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

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

Our Eligibility teams consists of professionals with experience in Member Enrollment, Eligibility Verification and Capitation Management

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

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

Our Fraud and Abuse Investigation team has vast experience in detecting and preventing overpayments due to fraud and abuse, incorrect coding and third party responsibility/liability.

Our UM team which comprises of medical personnel from physicians to certified coders, reviews and validates authorization of treatment request to ensure services rendered are medically necessary

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

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 Health Informatics team empowers clients with real-time and actionable data for Population Health Management. Data from claims, medical management and financial performance is integrated to give a holistic view

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

Vijay Datt

COO

Experienced Healthcare Leader with 20+ years of diverse experience; former Associate Partner at McKinsey advising C-suite at top national and regional Payors and Providers

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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