With over 30 years of quality improvement experience, CCME provides strategic expertise, evidence-based solutions, along with clinical knowledge and resources to state Medicaid departments, hospitals, accountable care organizations, and providers of all types. Our work focuses on:
- Review and Program Integrity
- Quality Improvement
- Consulting and Education
- Data Analytics
CCME’s Prepayment Claims Review program prevents fraud, waste, and abuse by ensuring that claims presented by a provider to a payer, either public or private, will meet benefit guidelines and medical necessity criteria in advance of payment. This is achieved through comprehensive, hands-on, clinically focused reviews.
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