Medi-Medi Data Analytics

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Medicare and Medicaid are both vast and complex programs on their own – both presenting difficult program integrity challenges. With millions of providers enrolled in both Medicare and Medicaid, as well as millions of beneficiaries who are eligible for both programs, many of these challenges are shared between Medicare and Medicaid, which complicates program integrity efforts. Protecting the integrity of two programs with different policies and different data can be extremely difficult. IntegrityM can help. We offer Medicare-Medicaid, commonly referred to as Medi-Medi, data analytics to enhance program integrity and combat cross-cutting fraud, waste, and abuse in Medicare and Medicaid.

If you would like to discuss Medi-Medi Data Analytics and fraud detection options for your organization, you can contact one of our specialists today at (703) 683-9600 or fill out our online contact form.

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Medi-Medi Data Support Services

The Centers for Medicare and Medicaid Services (CMS) established the Medi-Medi program to fight fraud, waste, and abuse in both Medicare and Medicaid. IntegrityM has years of valuable experience supporting Zone Program Integrity Contractors (ZPICs), Program Safeguard Contractors (PSCs), and state agencies participating in the Medi-Medi program. Under the new Unified Program Integrity Contractor (UPIC) model, CMS is combining Medicare and Medicaid program integrity audit and investigation work into a single contractor whose efforts should complement state audits and investigations. IntegrityM’s Medi‑Medi data analytics services can partner with your organization through this change.

IntegrityM develops analyses, generates leads, and supports investigations to combat fraud, waste, and abuse in Medicare and Medicaid. We are skilled at matching Medicare and Medicaid data at the provider and beneficiary level. This allows us to create comprehensive provider profiles that include billing patterns for both programs. Our Medi-Medi data matching analyses also allow us to quantify the full impact of a provider’s fraudulent activity on both Medicare and Medicaid.

With Medi-Medi data matching analyses we can also identify program vulnerabilities and overpayments in both Medicare and Medicaid. Problems can arise when both Medicare and Medicaid make payments for a claim. IntegrityM can use Medi-Medi data matching analyses to make sure that these claims are paid appropriately.

We are experienced in analyzing Medicare and Medicaid claims to detect fraud, waste, and abuse.  We understand the differences between Medicare and Medicaid benefits and adjust our analyses to account for these differences. We can also tailor analyses to different states. We use Medi-Medi data analytics to find a “bad actor” in one program, and determine if they are involved in fraud and abuse in another program.

Our Complete Approach to Medi-Medi Data Support

IntegrityM’s team of highly qualified analysts, statisticians, specialists, and investigators can offer the Medi-Medi data analytics your organization needs. Our team will work closely with your organization to meet changing program integrity expectations. We provide a full spectrum of Medi-Medi data analytics including policy research, Medi-Medi claims matching, fraud and abuse detection, and investigation support.

IntegrityM is innovative, accomplished, and committed to helping your organization succeed. Our Medi-Medi data analytics services have resulted in strong collaboration between Medicare contractors and Medicaid agencies, leading to successful efforts to stop fraud, waste, and abuse in both programs.

Contact the Specialists at IntegrityM

If you would like to speak to one of our experts about Medi-Medi Data Support click here or call (703) 683-9600.

 

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