Codice solutions are purpose built for organizations that require flexibility, technological expertise and rigorous compliance standards. Using a foundation of best practices from government and private company operations, we then customize our solutions to our clients’ technical, financial and industry requirements.
Healthcare Systems Administration
Codice supports a broad range of healthcare administrative and oversight processes. From eligibility and enrollment to controls and compliance, our solutions maximize efficiency and transparency.
- Eligibility and Third Party Liability
- Fraud and Abuse Control
- Medicaid Claims Processing
- Patient Account Systems
- Provider Credentialing
Eligibility and Third Party Liability
Ensuring healthcare dollars are paid by the right party on behalf of the right beneficiary is a critical function to healthcare program sustainability. Codice verifies eligibility for program enrollment and benefits; and helps manage the coordination of benefits process with third party payers to ensure accurate payments.
Fraud and Abuse Control
From claims reviews to risk assessments, Codice helps identify and investigate abnormalities, high risk claims, and outlier trends, to reduce fraud, waste and abuse on a pre- and post-payment basis.
Medicaid Claims Processing
Codice has been serving Medicaid programs for nearly a decade. We understand the complex array of federal, state, and local regulations and requirements that are necessary for accurate claims processing.
Patient Account Systems
Celermed accounting system is singular to a given patient including invoices, billing, payments, claims documentation and more.
Provider Credentialing
Codice performs verification and validation of healthcare provider credentials for enrollment in commercial payer networks and government programs such as Medicaid, Medicare, Children’s Health Insurance Program and others.
IT Consulting
IT resources can be scare. Codice provides the full range of IT expertise from staff augmentation to customized development.
- Application Development
- Customer Relationship Management (CRM)
- Customer Service and Help Desk
- Data Warehousing
- Enterprise Resource Planning (ERP)
- System Integrations
Application Development
Codice offers fully customized software development services including drafting requirements documents, programming (.NET, JAVA, SQL and all major platforms), testing, and bug fixes.
Customer Relationship Management (CRM)
CRM systems are only as good as their implementations and integrations with business processes. Codice will facilitate a successful CRM system launch by setting up workflows, data processes, dashboards and reports, user inputs, and linkage to key systems.
Customer Service and Help Desk
Staffing for customer facing positions is a key challenge for many organizations. Codice provides experienced customer service and technical help desk representatives to get your service functions staffed quickly. We provided fully outsourced departments or supplemental resources for existing customer service teams.
Data Warehousing
Codice provides development, implementation and maintenance solutions for data warehouses that enable your organization to perform trend analyses, forecasting and budgeting analyses, performance reporting, risks and outlier identification, data integration and other strategic business functions.
Enterprise Resource Planning (ERP)
Integrating enterprise data assets, business processes and governance are challenges that require specific expertise. Codice provides planning, implementation and monitoring solutions for content management, risk management and functional systems linkage.
System Integrations
Getting subsystems to function together as planned is our key expertise. Addressing both data synchronization and process integration, Codice uses open source tools and APIs to ensure continued flexibility for your systems.
Customer Service
From call center support to help desk operations, Codice’s solutions ensures your customers have a positive experience every time they connect with you.
- Customer Relationship Management (CRM)
- Customer Service and Help Desk
Customer Relationship Management (CRM)
CRM systems are only as good as their implementations and integrations with business processes. Codice will facilitate a successful CRM system launch by setting up workflows, data processes, dashboards and reports, user inputs, and linkage to key systems.
Customer Service and Help Desk
Staffing for customer facing positions is a key challenge for many organizations. Codice provides experienced customer service and technical help desk representatives to get your service functions staffed quickly. We provided fully outsourced departments or supplemental resources for existing customer service teams.
Finance Solutions
Codice provides expert consultation and outsourced solutions to support billing, reporting and revenue management.
- Electronic Cost Reports
- Forensic Audits
- Internal Controls
- Rate Setting Methodologies
- Risk Management
Electronic Cost Reports
Codice’s cloud-based software automates the cost reporting process and provides transparency, functionality and compliance not available in manual systems.
Forensic Audits
Whether seeking to identify potential fraud, conflicts of interest, or financial statement errors, or just wanting deeper assurance of the accuracy of financial records, Codice provides clients with audit planning, investigation, reporting and expert testimony.
Internal Controls
Codice provides planning, implementation and review/assessments of accounting and financial control procedures. Our experts will work with your financial, IT and operational departments to ensure policies and procedures are in place, employees are trained and operations / users are in compliance.
Rate Setting Methodologies
Codice helps public and government agencies develop rate setting methodologies using utilization data, risk assessments and state and federal requirements.
Risk Management
Codice provide a comprehensive risk management system and solution that has been used by numerous government agencies and corporations for over a decade. Contact Codice to learn more about our ICOSMOS system solution.