user

Cooperative Managed Care Services, LLC (CMCS)

Hospitals and Health Care

Overview

CMCS is a managed care support services company based in Indianapolis, Indiana. The company provides operational support services for the medical management and payment of health services. CMCS has experience administering HMO capitated contracts, Medicaid risk contracts and specialty product lines. CMCS is a full service TPA. The company has 120 employees. Organized in 1996, CMCS is jointly owned by St. Vincent Health and Franciscan St. Francis Health in Indianapolis, Indiana. Originally formed as a benefits administrator for the two hospital networks, CMCS currently provides services to 5 hospital delivery systems covering over 140,000 enrollees. CMCS has been certified as a Utilization Review Agent under the authority of the Indiana Department of Insurance since 1997. CMCS manages and supports fully insured products, self-funded products and integrated hospital delivery systems. Services currently provided by the company include: • Claims Administration • Integrated Care Management Services Including: o Complex Care Management o Disease Management o Prior Authorization and Utilization Review o Healthcare Coordination for Members o Quality Management Services o Population Health Management • Capitation Management • Reporting and Analytic Services • Scalable IS System Solutions, Database Administration and Network Support Services