PAYORS
  Your Members are Your Priority – Mazars Makes Your Business Ours
We guide you through end-to-end regulatory reviews, network expansion, reimbursement transformation, unit cost reduction and clinical/operational process improvements- helping you achieve stability and success.

  HOME HOSPITAL SYSTEMS PAYORS PHYSICIANS / ANCILLARIES PRIVATE EQUITY FIRMS INSIGHTS
   

We provide full-service consulting to national and local payors; Managed Medicare and Medicaid, Public and Private Exchanges, Workers’ Compensation / No fault and Commercial Plans.
Gil Enos | Principal
  916.696.3667
  Gil.Enos@MazarsUSA.com
  Detailed profile

 

Commercial
Medicare Advantage
Managed Medicaid
Managed Long Term Care
Dual Eligibles Plans
Plans for Developmentally Disabled
   Our Services

Industry InSights


Performance & risk based contracting   Vendor carve-out negotiations
Outsourced managed care contracting Narrow network design
Provider credentialing Unit cost reduction strategy
Integrated delivery system development Contract review & payment compliance
End-to-end network development Strategic alignment contracting
Fee schedule/capitation analysis  
IT governance   System evaluation & selection
IT strategic planning Contract review & negotiations
Cybersecurity System optimization & process workflow improvement
Cybersecurity Meaningful use & regulatory requirements
Network & telecommunications assessment planning Interim Leadership (CIO, CTO, PMO)
M&A/divestiture planning & execution   Technology & process evaluation
Buy/sell-side transaction analysis Organizational & operating model assessment
Valuation services Business intelligence & maintenance
Financial modeling  
Revenue cycle assessment & transformation   Inpatient & outpatient coding & documentation improvement
Point of service collections Regulatory Compliance
Cash position improvement Monitoring services for CMS & state regulatory bodies
Charge master review Readiness assessment surveys and audits
Charge capture optimization & system alignment Corrective Action Plan (CAP) development & implementation
Strategic repricing of services Telephone/on-site surveys
Compliance & self-disclosure reviews State & federal filings for new or expanding networks
Collection agency/external vendor analysis Interim management & staffing resources
Denial management and mitigation Expert witness testimony
Claims audits Organizational readiness assessment
Interim CFO management services  
Prescriptive analytics   Predictive analytics (re-admission, early identification of high utilizer)
CMS & state exchange risk modeling Dashboard development
Value based modeling & reporting Business intelligence & maintenance
Descriptive & comparative analytics (utilization, financial, quality)  

 
LEADERSHIP

Our team is made up of professionals with decades of C-suite and advisory experience in the healthcare industry.
 
We are more than just competent technical resources – we provide timely, valuable information and insights into policies, best practices and industry developments. We are committed to providing value-added services – from audits and feasibility studies to information technology consulting, managed care contracting, and revenue cycle management. Our background
serving at or providing close consultation to many hospitals and medical facilities throughout the United States gives us a unique level of insight into client needs and best practices. This depth of expertise allows us to give clients a higher level of value and individual attention.
 

PAYORS

Your Members are Your Priority – Mazars Makes Your Business Ours
We guide you through end-to-end regulatory reviews, network expansion, reimbursement transformation, unit cost reduction and clinical/operational process improvements.- helping you achieve stability and success.

Our Services

Industry InSights

Gil Enos | Principal
  916.696.3667
  Gil.Enos@MazarsUSA.com
  Detailed profile