More Than 40 Years of Expertise

Health Care Excel serves clients by providing solutions for utilization review, quality improvement initiatives, data analytics, and strategies to combat healthcare fraud, waste, and abuse. We work with health plans, health care providers, state and federal governments. Health Care Excel also provides Initial Validation Audit services for health plans as part of the Commercial Risk Adjustment Data Validation Program under the Affordable Care Act (ACA RADV).

We employ highly skilled professionals including physicians, nurses, dentists, dental hygienists, researchers, data analysts, and other experts to ensure measurable results through a variety of services.

Program Integrity
Consulting
Commercial Risk Adjustment
proActive Management

Our History

Incorporated in 1974, Health Care Excel was established to provide clinically based, objective, and independent monitoring of the quality, appropriateness, and medical necessity of health care services. Serving clients in the private sector and state and federal governments, we have a record of exceptional performance.

How we help

Health Care Excel achieves results by leveraging sophisticated data analysis with hands on expert reviews from our medical and dental teams. Learn more about how Health Care Excel’s interdisciplinary strategy can protect your organization.

Accreditation & Membership

URAC independent review organizationHEDIS Certified Measures 2015HEDIS Pay For Performance P4P Measures 2015HUMSeal2
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