Knowledge. Experience. Trust.
We offer comprehensive call log reviews, Centers for Medicare and Medicaid Services (CMS) guidance updates, member material reviews, Part D rejected claims reviews, universe monitoring, CMS Independent Validation Audits and support, Part C claims processing audits, fraud, waste and abuse (FWA) action plans, and prescription drug event (PDE) management.
Solutions by Market
BluePeak is a leading national healthcare consultancy that focuses on government programs including Medicare Parts C and D, Medicaid, and Exchanges. We assist health plans, pharmacy benefit management (PBM) companies allied health companies and pharmaceutical manufacturers with regulatory, operational and compliance issues. BluePeak can analyze an organization’s processes and provide practical solutions, operational best practices and training to meet Medicare and other government program standards in all key areas.
“BluePeak asked all the right questions to help us effectively prepare for our CMS Program Audit tracer review sessions. In fact, after BluePeak’s pivotal guidance on how to strengthen our tracer summaries and how to think through the way in which to best answer the tough questions we might be asked by CMS, we ultimately had no findings during the CPE portion of our CMS Program Audit (even on the tracer summary we were most concerned about). BluePeak’s CMS Program Audit support prep was invaluable to helping us thoroughly prepare, present with confidence, and drive our positive outcome.”
Medicare Compliance Officer, Fortune 50 Company
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