Reden & Anders has a large staff of accredited actuaries to help you prepare and certify your reserve levels for the annual statements. In many cases, we also develop IBNR estimates for our clients at other times during the year (quarterly or monthly). This ongoing IBNR process helps to provide senior management with the comfort of outside expert opinions on reserves and decreases unpleasant surprises at the end of the year. We developed these tools utilizing the internal actuarial techniques for estimated reserves.

Reden & Anders’ Medicaid staff can assist your organization in completing your state-specific rate development process including competitive bidding situations or completing the required rate filings. Our extensive Medicaid experience can help your organization maximize your Medicaid programs revenue. Our services range from completing the required forms or bid sheets to an extensive evaluation of your organization’s historical costs and prediction of future expenditures.

Reden & Anders offers state-of-the-art financial and actuarial consulting services and expertise in operational consulting. We can provide valuable consulting services for a number of Medicaid specific operational areas including, but not limited to, medical management, fraud and abuse, and grievance and appeals. The various Medicaid populations require different medical management protocols and grievance and appeals policies and procedures vary from state to state. Our expert staff of clinical and operational consultants can help your organization navigate these areas and develop best practices.

Reden & Anders Medicaid experts can assist your organization in evaluating the feasibility of a Medicaid program. We have a thorough understanding of Medicaid eligibility categories and services from evaluating acute services for a TANF program to long term care services for a dual eligible population. Many states are moving toward more complex payment structures including those based on evaluating the underlying health status of the population; we have the expertise and tools to help your organization achieve its financial goals.

Reden & Anders provides detailed financial analytics for provider contracts including facility, physician, and ancillary services. Many Medicaid health plans utilize the state fee-for-service Medicaid provider contract as the basis for their own provider contracts. These provider contracts often contain complex structures that can be difficult to analyze. We have the tools and expertise to effectively investigate these complex contracts and provide meaningful analyses.

Reden and Anders medical trend experts employ sophisticated tools and consulting services to help your organization measure historical medical trends and forecast future trends. The Medicaid population has inherent characteristics that must be considered when evaluating trends. Our experienced staff incorporates these Medicaid analytics and tools. Understanding and projecting medical trends is critical to the success of your organization and most operational areas benefit from the results of a thorough trend analysis. Our expert consultants go beyond reporting historical trends to make recommendations for trend mitigation opportunities.