Comprehensive integrated platform managing capitation, claims, referral authorizations, member services, care management, eligibility and ease of exchange of data with provider and third party solutions.
In supporting the delegated model, Citra provides all of the tools necessary to manage the financial risk for healthcare services is transferred from an insurance company to healthcare providers (e.g., physicians or hospitals), such as capitation for all professional services for each health plan member, and variations, such as full or partial risk for hospital services provided to those same members, as well as manage shared risk arrangements for hospital expenses, sharing with the health plan in any differences between actual and budgeted hospital expenses and to supporting acceptance risk for all healthcare services, global or full-risk capitation.
EZ-Suite, Citra's comprehensive technology platform and advanced population health analytics enable IPAs managing their own risk directly, the ability to adress critical fucntions without outsourcing to MSOs or TPAs, ensuring you succeed in all aspects of delegated risk management.
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