September 26, 2014

CLEVELAND – Medical Mutual, Altegra Health Partnership Provides Enhanced Care and Services for Members

Medical Mutual of Ohio is partnering with Altegra Health to provide a variety of member healthcare enhancements and assist the insurer in filing data with the federal government under terms of the Affordable Care Act (ACA).

Member services provided by Altegra Health will include assistance in making medical appointments and reminders to members regarding preventive services.

Medical Mutual Members receiving appointment scheduling assistance may be overdue for important preventative care, screening, or their annual wellness exam. Altegra Health’s analytical services utilize claims data and member communication to identify patients who meet these criteria.

When performing appointment scheduling, an Altegra Health advocate will be on the phone with the member and the member’s provider to assist in scheduling. In some cases, Altegra Health will even assist the patient with transportation and other services that may help the member get to the appointment.

Altegra Health will also provide Medical Mutual with Risk Adjustment processing services to ensure accurate ACA-required data that the company files with the federal government.

The Risk Adjustment program, one of the provisions created by healthcare reform, is designed to lessen the financial risk insurers face when enrolling individuals and small groups on and off the healthcare exchanges.


About Medical Mutual: Founded in 1934, Medical Mutual of Ohio is the oldest and largest health insurance company based in Ohio. For 80 years, the company has served customers with high-quality, affordable group and personal health insurance plans, and third-party administrative services to self-insured group customers. Medical Mutual is ranked highest in satisfaction among the six health plans in the Ohio region, according to J.D. Power 2014 Member Health Plan StudySM. The J.D. Power annual study was based on responses from health plan participants statewide, measuring member satisfaction on overall experience with key factors such as: Customer Service, Cost, Coverage and Benefits, Claims Processing, Provider Choice, and Information and Communication. The J.D Power Member Health Plan Study measures member satisfaction among more than 136 health plans in 18 regions throughout the United States by examining the experiences of a health plan member. As a mutual health insurance company, Medical Mutual is unique in that it operates for the benefit of its members. Unlike publicly-traded insurance companies that must maximize their financial return, Medical Mutual does not answer to stockholders or Wall Street analysts.

About Altegra Health: Altegra Health™ is a leading provider of technology-enabled business and consulting services that enhance quality, strengthen compliance and optimize financial performance for healthcare organizations. As a quality and care revenue management solutions partner, Altegra Health serves Medicare Advantage, Managed Medicaid, and Health insurance Marketplace/Exchanges health plans to integrate key area of financial performance and continuity of care while improving the quality of life of the individuals they serve. For more information, visit