We help health plans and risk-bearing providers improve outcomes across their risk adjustment and quality programs.
IRVINE, Ca – March 11, 2026 – Advantmed, LLC, an industry leader in risk adjustment and quality services for health plans and providers, today announced that Vijay Prabhakar has joined the company as Chief Revenue Officer (CRO). Vijay brings more than 20 years of experience driving revenue growth and leading high-performing sales organizations across the healthcare… Continue reading Advantmed Appoints Vijay Prabhakar as Chief Revenue Officer
Outcome-based model eliminates financial risk and helps plans close more HEDIS gaps using existing medical records IRVINE, Ca – March 5, 2026 – Advantmed, a leading provider of risk adjustment and Quality improvement solutions, today announced the launch of its Pay for Quality: HEDIS® Abstraction offering—an industry-first, outcome-based solution that enables health plans and risk-bearing… Continue reading Advantmed launches Pay for Quality – the industry’s first HEDIS® Abstraction Solution, Enabling Health Plans to Pay for Outcomes, Not Charts
IRVINE, Ca. – March 3, 2026 – Advantmed, LLC, an industry leader in risk adjustment and quality services for health plans and providers, today announced the appointment of Dr. Matt Lambert as Chief Medical Officer and Head of Product Strategy. Dr. Lambert brings more than two decades of clinical experience and extensive executive leadership in… Continue reading Advantmed Appoints Dr. Matt Lambert as Chief Medical Officer and Head of Product Strategy
Irvine, CA – August 5, 2025 — Advantmed, LLC is proud to announce that it is now accredited by the National Committee for Quality Assurance (NCQA) in Credentialing. This prestigious three-year accreditation validates the thoroughness and integrity of Advantmed’s Nurse Practitioner credentialing process, confirming the company’s strict adherence to the highest national standards and its… Continue reading Advantmed’s Nurse Practitioner Credentialing Process Earns Full NCQA Accreditation
FOR IMMEDIATE RELEASE IRVINE, Ca., April 2, 2025 – Advantmed, LLC, an industry leader in risk adjustment and quality services for health plans and providers, today announced that it has welcomed Scott Filiault to its Board of Directors. Scott brings over two decades of business development experience in the payer and provider space including leading… Continue reading Advantmed, LLC Welcomes Risk Adjustment and Quality Expert Scott Filiault to its Board of Directors
Irvine, CA – August 10, 2022 – Advantmed, LLC, a healthcare solutions company focused on integrated quality improvement and risk adjustment optimization, announced today that it has received certification from the National Committee for Quality Assurance (NCQA) for all HEDIS® MY 2022 measures. Advantmed’s admin and hybrid measures were certified in July.
Santa Ana, CA — April 12, 2018 — Responding to the recent release of the 2019 Medicare Advantage and Part D Rate Announcement and Call Letter, Advantmed, LLC, an integrated risk-adjustment optimization and quality improvement company, announces the release of its Fact Sheet, highlighting key points to help Medicare Advantage (MA) plans to understand the implications and prepare for… Continue reading Advantmed Advances Payer Understanding and Preparation for 2019 Medicare Advantage and Part D Rate Announcement and Call Letter, Issues Fact Sheet
Santa Ana, CA — February 14, 2018 — Advantmed, LLC, an integrated risk-adjustment optimization and quality improvement company, today introduces Physician Record Review (PRR), a two-stage retrospective chart review process, first by a certified coder and second with a board-certified physician. This empowers Medicare Advantage (MA) plans with clinical insight into risk adjusting conditions to enhance traditional… Continue reading Advantmed Physician Record Reviews: Medicare Advantage Plans Gain Clinical Insights for Risk-Adjusted Conditions and Quality/Care Management Opportunities, Impact HCC Coding & CMS Reimbursement
Irvine, CA – November 4th, 2021 – Advantmed, LLC, a healthcare solutions company focused on integrated quality improvement and risk adjustment optimization, announced today that
Advantmed’s Elevate^ Quality Insights® software is certified for the MY 2021 IHA AMP measures
