Working with you to take Healthcare
to the next level

WHAT WE DO

Millions Lives Served

States Covered

% Quality

HEALTHCARE
ADMINISTRATION

  • Comprehensive suite of Healthcare administrative services

  • Broad range of clients from national/regional Payors & Providers

  • Innovative service models

MEDICAL
MANAGEMENT

  • Offering cloud-based solutions and mobility solutions

  • Integrated UM & CM offerings for better outcomes/ cost of care

  • Tech-enabled Medical Management services

POPULATION HEALTH
MANAGEMENT

  • Innovative dashboards and reports to track ongoing performance

  • Comprehensive solutions to support population health management & value-based reimbursement

SERVICES

We offer support to New MSO buildouts across three key areas including System Evaluation & Selection, Process & Org Design and Delegation contracting and Pre-delegation readiness

Our dedicated Claims Examiners teams consist of experienced & dedicated healthcare claim adjudicators who provide services to several healthcare orga-nizations such as HMO, MSO, IPA & Physician Medical Groups

Our Benefits team provides clients with a standard benefit plan setup & interpretation, with standard event classes & benefit rules. We handle benefit calculations, calculating OOP from plan cost & tracking benefit costs

Our EDI team uses enhanced OCR technology for efficient & accurate Claims Data capture which is then verified for correctness in accordance to client specifications

Our Eligibility specialists support a stringent process of verification of member eligibility records and update of Claims systems with missing Eligibility details

Our UM team is comprised of medical personnel from certified coders, RN’s and physicians to review and validate treatment requests and ensure services rendered are medically necessary and clinically appropriate

Our Review team performs an increased level of research, investigation and evaluation of clinical data in compliance with protocol and overall clinical objectives

Our CDI specialists are responsible for reviewing medical records to facilitate accurate representation of the severity of illness

The HCC team comprises of expert, clinically-trained coders (CPC, CPC-H) and physicians who engage in highly efficient chart reviews to recover valuable ICD-9/10 codes for health plans, MSO, IPA and Medical Groups

Our Financial Risk Management team works with clients to formulate strategies around value-based reimbursement models. We also provide tools to manage and track performance on risk-pool revenues

Our Care Management team includes highly trained coordinators and nurses, who work with high-risk members in various care settings from post-discharge follow-ups to chronic disease management

Our Readmission Reduction and ER diversion programs involve High intensity interventions for High risk patients

Nurse Advice Line staff can help you decide what kind of care to seek, whether to treat the condition at home, see your doctor, or need to get urgent or immediate care. If you have a life-threatening medical emergency, 
call 911

Our wellness programs boost your employees’ overall wellness with a Healthy Living program. Investment in a wellness program delivers positive results for both the employer and the employee

Our Predictive Modeling and analysis team leverages cutting edge technology for tackling complex problems like risk stratification and proactive identification of high-risk patients

LEADERSHIP

Madhu Vijayan

PRESIDENT

25+ years of leadership in Private Equity/Venture Capital world managing and investing across a diverse portfolio across industries mainly in Asia and North America.

Jovita Montes De Oca

CEO

Seasoned healthcare executive with 30+ years of diverse management experience in the healthcare industry; extensive experience in IPA and MSO Management

Gary Ashburn

VP, Global Operations

Healthcare leader with 25+ years of diverse experience across all phases of operations, managed care and regulatory compliance.

Dr. Richard Sánchez

CMO

30+ years of senior executive level experience with some of the the nation's largest managed care companies

Mark Broido

CFO

Senior executive with 15+ years of experience leading financing rounds for high growth start-ups; former strategy consultant at Monitor

Atul Sharma

VP, OPS

Extensive experience planning and strategizing healthcare business operations in an offshore services environment

CONTACT

Headquarters

  • 1601 Monte Vista Ave.,Suite 250,
    Claremont CA 91711

  • (866) 955-0044

  • (909) 605-0044

  • (877) 891-7292

  • info@calibratedhealthcare.com

India Office

  • 516, Udyog Vihar, Phase III, Gurgaon. 122015

  • +91-124-4171500

  • +91-124-4006016

  • info@calibratedhealthcare.com

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