GORMAN HEALTH GROUP’S VALENCIA REACHES $20 BILLION IN CAPITATION MANAGEMENT
WASHINGTON, DC September 5, 2012 — Gorman Health Group, leading consulting and solutions provider to companies in Medicare Advantage and Part D, is proud to announce that their premier financial reconciliation software, Valencia, now manages $20 billion USD in Medicare capitation payments.
With almost 6 million beneficiaries under its management, Valencia serves as a plan’s single source for CMS membership, payment and reconciliation data. This software also connects PDE data with membership discrepancies, manages Coordination of Benefits and Medicare Secondary Payer activities, addresses Out of Area discrepancies within plan data, and more.
Valencia is the first capitation management software designed specifically for Medicare Part C and D contractors. Available as a complete workflow management tool or as task-specific modules, Valencia integrates plan data, CMS data and operational workflow controls to ensure timely, accurate and compliant reconciliation work by health plan processors. Across both its technology tools and its professional services, Gorman Health Group solutions are designed around identifying and fixing the root cause issue to deliver plans lasting results.
“Correct payment from CMS requires airtight controls on operational workflow,” said Aaron Eaton, Senior Vice President of Consulting Services at Gorman Health Group. “Financial Officers must have insight into the state of operations in order to more correctly project revenue. And operations staff needs to understand the financial implications of these critical plan functions. This tool breaks down the walls between departments and streamlines revenue management.”