ComplexCare Solutions

ComplexCare Solutions is a leading provider of Member Engagement and Health Information Management services for health plan networks nationwide. Our goal is to engage members, collect comprehensive patient data, and implement personalized care plans that drive real change and bring patients closer to their desired outcomes.
With decades of experience working with health plans of all sizes, we understand the challenges faced by your business in the ever-evolving healthcare landscape. Our team possesses a profound understanding of your needs and is committed to helping you achieve your goals. Our modular services seamlessly integrate with your health plan's operations throughout the entire care management continuum. By partnering with us, you can ensure compliance, receive appropriate reimbursements, reduce healthcare costs, and enhance member satisfaction and care quality.
We serve a diverse range of members, including Medicare Advantage, Medicaid Managed Long-Term Care, Dual-Eligible, Managed Medicaid, Commercial ACA, and General Commercial Populations. As an ACAP-endorsed organization, we extend our assessment and care management services across the United States.
Key Services:
Member Engagement: We offer in-home health risk assessments, annual wellness visits, health screenings, support for vaccine adherence, continuity of care, and CAHPS surveys. Additionally, we provide over-the-phone outreach coordination for comprehensive member engagement.
Health Information Management: Our experienced medical coders specialize in medical record retrieval for retrospective risk score accuracy and HEDIS® reporting. We offer various collection methods tailored to your organization's preferences, including clinical data extraction, remote EHR access, onsite data collection, and record requests.
Choose ComplexCare Solutions as your trusted partner to enhance member engagement, optimize health information management, and achieve your healthcare objectives