Health Plan Management Patty Bailey CEO Peak Health
Health Plan Management Patty Bailey, CEO Peak Health Plan Management Services 1
About Us � � � Located in St. Louis, MO – Central Time Incorporated July 1, 2009 by Altitude Edge Began serving clients March 1, 2010 Acquired by Tabula Rasa May 1, 2018 Service of Capstone Performance Systems Provide Full Services � 44 PACE organizations with over 10, 000 total members � Provide Part D Services � 12 additional PACE organizations
Ind ust ry s exp p erie ecific nce Peak Offers Comprehensive support e vic r e s e l s ib e x g e Fl ka c a p Versatile reporting mechanisms User friendly software
Industry Specific Experience � Patty Bailey, CEO ◦ Began PACE career in 1999 � Bill Wieher, Senior Director of Plan Operations ◦ Began at On. Lok in � Jennifer Hodge, Director of Technology & Client Development ◦ Began at Tri. Health Senior Link in 1999 4
Comprehensive Services � Enrollment Management Services � Accounts Receivable � Claims Adjudication and Payment � Incurred But Not Reported (IBNR) Calculation � Risk Adjustment Submission � Encounter Data Submission � Part D Services 5
Software and Reporting �A Version of Cognify’s PACElogic software � User friendly � Easy navigation � Data imports & exports � Library of standard reports ◦ ◦ ◦ Utilization by type of service Cost by participant RAPS PDE Part D reserve reports 6
Part D Services � Partner with Care. Kinesis � PDE Submission � Plan to Plan (P 2 P) reporting � Tr. OOP Notifications to participants upon disenrollment � Audit Support 7
Questions Peak Health Plan Management Patty Bailey, CEO 345 Marshall Ave. Ste. 101, St. Louis, MO 63119 314 -474 -7342 pbailey@peakpacesolutions. com
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