PDF · 3 pages
Every Risk Score. Fully Reconciled.
A concise, three-page look at how Falcon connects contract-aware risk-score calculation, payer and CMS reconciliation, recapture, and AI-supported suspect review.
View the brochureResources - Practical guidance for healthcare operators
Concise, evidence-based guides for the teams responsible for making healthcare data accurate, compliant, and actionable.
PDF · 4 pages
Targeted Outreach. Measurable Correction.
A concise four-page summary of how human-reviewed, client-sent provider outreach was followed by measurable claim corrections and promising—but exploratory—changes in future payment.
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PDF · 16 pages
Effectiveness of Targeted Provider Outreach Letters: A Retrospective Comparison of Client Test Sent Letters and Client Control Drafted-but-Unsent Letters
A 16-page retrospective study comparing sent provider outreach letters with drafted-but-unsent controls across earlier-claim reversals and subsequent payment.
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PDF · 4 pages
What “Right” Looks Like: Diagnoses & Procedure Codes for PACE Center MA Encounters
A practical, four-page guide to the procedure codes, encounter data, and documentation practices that help PACE risk-adjustment diagnoses count.
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PDF · 25 pages
From Prediction to Explainable Provider Behavior Profiles for Fraud, Waste, and Abuse Review
A practical framework for turning claims data into interpretable provider behavior profiles that help fraud, waste, and abuse teams understand what changed and where to investigate.
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PDF · 12 pages
Anomalous Urinary Catheter DME Billing Patterns in Medicare: ACO-Affiliated Beneficiaries at Disproportionate Risk
An analysis of the rapid growth in urinary catheter billing, the suppliers driving the increase, and the disproportionate financial exposure borne by ACO-affiliated beneficiaries.
Read the white paperBring the question your team needs to answer.
See how Falcon connects your care, payments, and performance work with the evidence your team needs to act.
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