GAINWELL

Downloadable or recorded computer software for use in the management and administration of Medicaid and other health and human services programs; downloadable or recorded computer software for use in quality reporting to ensure accurate reporting of healthcare costs; downloadable or recorded computer software for use in analyzing and generating reports on health care data; downloadable or recorded computer software for use in identifying and managing procedures and providers that are above average costs; downloadable or recorded computer software for use in data warehouse management in the field of health care

Consulting services related to consumer information regarding Medicaid and other health and human services programs options; business consulting in the fields of Medicaid and other health and human services programs; business management of Medicaid and other health and human service programs; business administration concerning Medicaid and other health and human services programs; business functions on behalf of Medicaid and other health and human services programs, namely, financial records management of insurance claims and payments, maintaining registries of health care providers in the nature of storing, maintaining and tracking accurate provider information

Fiscal agent and management services to operate business financial and financial analytics functions on behalf of Medicaid and other health and human services programs, namely, processing and payment processing of healthcare provider insurance claims, facilitating prior authorization of insurance coverage for medical procedures, management and documentation of pharmacy benefits, health program insurance eligibility screening and processing services, and administration of insurance programs, namely, enrollment and onboarding services for eligible members and recipients; financial and insurance consulting in the field of Medicaid and other health and human services programs; organizing Medicaid and other health and human health care service programs; administering and managing Medicaid and other health and human services programs concerning insurance and finance; insurance administration concerning Medicaid and other health and human services programs

Computer software as a service services for use in the management and administration of Medicaid and other health and human services programs; computer software as a service services for use in quality reporting to ensure accurate reporting of healthcare costs; computer software as a service services for use in analyzing and generating reports on health care data; computer software as a service services for use in identifying and managing procedures and providers that are above average costs; computer software as a service services for use in data warehouse management in the field of health care; providing an interactive website featuring technology that allows users who are Medicaid enrollees to have access to their health profiles and self-assessment tools for personal wellness options and benefit details regarding Medicaid and other health and human services programs; providing a website featuring technology enabling business process services, namely, claims processing, clinical pre-authorization, utilization management, call center operations and mail room operations, for use in the delivery of Medicaid and other health and human services programs; development, implementation and management of information technology systems as a service in the field of healthcare and information technology; implementation and operation of computer software as a service services for use in the secured transmission of health information, clinical data and administrative transactions; providing temporary use of on-line non-downloadable software for use in the management and administration of Medicaid and other health and human services programs, quality reporting to ensure accurate reporting of healthcare costs, analyzing and generating reports on health care data, identifying and managing procedures and providers that are above average costs and data warehouse management in the field of health care

Compiling and analyzing statistical health data in order to uncover and identify health care fraud and claims errors