Program Operations

The transition to a prospective bundled portfolio care model creates new operational demands. GHA offers providers operational and administrative capabilities ranging in scope from tactical support for specific functions to end-to-end outsourced support for program operations.

This operational capability is delivered in four main categories:

Patient Experience
Comprising patient outreach, engagement, communication, and financial engagement, GHA Patient Experience services support the patient onboarding process from initial inquiry through registration, enrollment, and payment.

Program Administration
GHA supports day-to-day clinical operations through patient identification, access coordination, and financial monitoring of care episodes, from admission to discharge. Our objective throughout is to allow physicians and other care providers to concentrate on providing excellent care with no concerns about administrative efficiency.

Contracts, Collections, and Finance
Commercial value-based care programs are built on detailed contracts between providers, payers, and employers. GHA can manage contracting and contract administration in value-based programs. Funding and collections are another service area. GHA manages patient collections and payer reimbursement, as well as reserves, risk management, and incentive structures. Finally, we provide financial reporting for operations and clinical performance analytics.

Provider Billing and Reimbursement
GHA provides provider billing services, including electronic claims submission and conversions of fee-for-service billing to bundled price billing. We also administer provider reimbursement, including the unbundling of accounts payable, the electronic production and reconciliation of Explanations of Benefits (EOBs), payment (by check or electronic transfer), and risk pool management.

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