Education and Training
Strategic designs, develops, produces, and delivers education and training materials for a wide range of audiences. Our experienced staff has developed a variety of plain language materials, such as brochures, fact sheets, press releases, reference guides, PowerPoint presentations, and marketing products. We also produce and distribute web-based training courses, classroom materials, and awareness campaign products.
Medical Review
Strategic provides medical review services that support many different functions, including medical management policy review, overpayment calculation, fraud case support, expert testimony, appeals and grievance support, and coding validation. We make decisions that are based upon defined criteria, are supported by regulation, and meet high standards of quality.
Monitoring and Compliance
Strategic provides compliance and regulatory monitoring audits. Areas of focus include medical management oversight, detection of aberrancies through data analysis, overpayment identification, and detection of program vulnerabilities. Audit tools are tailored to each audit type and include methods to determine compliance with organizational policies and procedures and regulatory requirements.
Auditing and Investigation
Strategic conducted fraud investigations for Medicare Part D and provided legal support on fraud referrals to law enforcement. In addition, Strategic was responsible for developing outreach to provider and beneficiary groups and law enforcement on the role of the Medicare Drug Integrity Contractor (MEDIC).
Enrollment and Eligibility
Strategic provides enrollment and eligibility services for a variety of different Government programs. We screen applications to verify compliance with enrollment standards, determine whether the information is sufficient, and process enrollments.
Core Service Offerings:
- Education and training material development and delivery
- Medical review
- Claims review
- Appeals and grievance support
- Enrollment and eligibility standards compliance
- Overpayment calculation
- Medical management policies review
- Quality of care review
- Expert testimony
- Fraud case support
- Coding validation