Risk Adjustment · Medical Coding · Healthcare OpEx

Operational excellence for risk adjustment and value-based care.

CICARE Business Solutions supports IPAs, clinics, ACOs, and payers with disciplined risk adjustment, medical coding, billing, and back-office operations — built to drive sustainable performance in value-based care.

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Founded 2020 · Katy, TX

Team 120+ across US & India

Supporting

IPAs

Physician Practices

Clinics

ACOs

Health Plans & Payers

Healthcare Services

Four service areas. One accountable partner.

Specialized teams for risk adjustment, coding, care management, and patient engagement — built around the operational realities of value-based care.

Risk Adjustment

Proactive, compliant HCC coding — prospective, concurrent, and retrospective. Accurate RAF capture with audit-defensible documentation.

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Medical Coding & Billing

Certified coders deliver clean claims across ED, E&M, HEDIS, radiology, anesthesia, ambulance, and full revenue cycle management.

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Care Management

Turnkey CCM and RPM programs that drive outcomes, close gaps, and capture recurring CMS reimbursement — handled by our team under your name.

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Patient Engagement

Inbound and outbound contact center, HEDIS gap closure outreach, review management, and multilingual patient communications in English and Spanish.

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All healthcare services

The Value-Based Care Reality

VBC demands precision across risk, quality, and operations.

Risk adjustment accuracy directly impacts financial performance. Quality measures stay under constant scrutiny. Regulatory and audit requirements continue to intensify. Internal teams are stretched across competing priorities.

When execution breaks down: undercaptured RAF, missed HCCs, unidentified or late gap closures, coding inaccuracies, and revenue leakage. The cost compounds.

Our role: Establish disciplined processes that drive consistent VBC performance. Closing gaps at the point of care can yield up to 4× the value compared to retrospective outreach.

Our healthcare approach

4×

Value of concurrent gap closure compared to retrospective outreach

By the numbers

2020Founded in Katy, TX

120+Employees across US & India

4×Concurrent vs retrospective value

100%HIPAA-compliant operations

Proven Results

What disciplined operations actually deliver.

Three recent engagements with healthcare clients across Texas — measurable outcomes, not promises.

60%cost reduction

Primary Care Clinic

Houston, TX · 22+ providers

Built an inbound & virtual assistant team during the 2020 hiring constraint. Cut average call wait from 5 minutes to under 30 seconds with 90% utilization of staffed resources.

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2.2 → 4.4Google rating

Internal Family Practice

8 locations · Harris, Walker, Montgomery

Stood up a structured post-visit feedback process with QR-code-driven Google reviews. Average rating doubled from 2.2 to 4.4 stars across all locations.

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$400K+added annually

Family Practice Group

Multi-county Texas · Value-based care

Dedicated HEDIS & quality assurance team focused on Stars measures and Med Adherence. Reached 4-star overall rating and added $400,000+ in annual revenue.

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Ready to streamline your operations?

Tell us about your organization and what you need. We'll respond within one business day with a tailored proposal.

Request a Consultation Call +1 (936) 371-3898