Who We Help
PPI's software is designed to seamlessly integrate and manage a diverse array of healthcare plans, including Medicare, Medicaid, PACE (Program of All-Inclusive Care for the Elderly), REACH (Regional Extension Centers), Fee-for-Service (FFS), and Private Pay programs. By leveraging advanced algorithms and a user-friendly interface, the software ensures accurate claims processing, compliance with regulatory requirements, and efficient coordination of benefits across different plans. Its robust data management capabilities allow for real-time tracking of patient information, billing, and reimbursement processes, ultimately enhancing the operational efficiency and financial performance of healthcare providers. This comprehensive approach ensures that providers can deliver high-quality care to patients enrolled in various healthcare programs while maintaining streamlined administrative workflows.
Medicaid
PPi’s software and services were originally designed to support Medicaid MLTC and dual waiver programs. Over the years PPi has added support for Special Needs Plans as well as other Medicaid state specific requirements. Medicaid is a government program offering health coverage to low-income individuals and families. It helps pay for medical expenses like doctor visits and hospital stays. Funding comes from both federal and state governments.
Medicare
PPi’s software and services support Medicare health insurance plans for people age 65 and older, people under 65 with certain disabilities, and people of all ages with End-Stage Renal Disease (ESRD). PPi supports all Medicare plans including: Hospital Insurance (Part A), Supplementary Medical Insurance (Part B), Medicare Advantage (Part C), and Medicare Prescription Drug Benefit (Part D). Our main focus is on the Original Medicare program (Parts A and B), as well as Medicare Advantage.
ACO REACH
PPi's software supports REACH. The Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model is announcing a coordinated set of changes starting in performance year 2025 (PY 2025) in response to findings from the PY 2022 Global and Professional Direct Contracting Model Evaluation Report and feedback from interested parties. The changes include adjusting the financial methodology to reduce net losses to CMS as described in the PY 2022 Evaluation Report, improving the accuracy of benchmarks in response to feedback, and strengthening operational flexibility and risk management.
PACE Programs
The PACE (Program of All-Inclusive Care for the Elderly) program helps older adults stay in their homes by providing a range of services, including medical care, social support, and transportation. Participants get a personalized care plan from a team of healthcare professionals. PACE covers all related costs, aiming to keep seniors in their communities rather than moving to nursing homes. PACE Programs are supported by PPi's software and services.
Fee-for-Service
FFS
PPi’s software and services support fee for service plans. Our products and services are built on the ability to stream line the process of health care for these plans as well as optimize the process of managing health care data.
Private Pay Plans
PPi’s software and services support complex private pay plans. Our platform and experience provides the added advantage of flexibility in customization of your workflows. Private pay plans are unique and do not require the rigidity of government driven plans. This uniqueness allows PPi to shine with our ability to meet these needs quickly and provide efficient user workflows and automation.
