CGI Group Inc. today announced it was was awarded a $13.3 million benefits-funded contract to provide Medicaid Recovery Audit Contractor program services for the Colorado Department of Health Care Policy and Financing.
The program supports the department“™s identification, correction and prevention of improper Medicaid payments.
CGI said it will audit all Medicaid claims, managed care and Child Health Plan Plus on the seven-year award. It will also conduct medical necessity and credit balance reviews.
To accomplish this, CGI said it will utilize its customized audit system, which is an enterprise-wide solution it uses to help predict, identify, manage and analyze medical and pharmacy claims.
The system includes provider outreach and education, appeals support and a web portal for program transparency.