Cap Check ™

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Are you being paid correctly for your members?

Cap Check is an essential tool for any company receiving capitation or other payments for large numbers of members. By reconciling actual payments with expected payments, you can verify whether you are being paid correctly, and make corrections when you are not.

Clients have reported substantial recouped payments as a result of using Cap Check.

Key Features

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• Reconcile health plan cap data against eligibility data.
• Identify missing and incomplete payments.
• Calculate expected cap payments based on contract rate tables using fully customizable rate calculators.
• Track exceptions from month-to-month.
• Generate detail and summary reports.