Clear Capitation Information

ClearCapitation recovers $75k–$500k+ in underpaid ESRD capitation for Medicare Advantage plans (5k-200k members) — on contingency, no upfront cost. We find coding errors related to End-Stage Renal Disease (ESRD) in CMS monthly payment files. Standard risk adjustment audits don't catch it, most plans aren't monitoring for it, and it compounds every month it goes unfixed. Our process combines plan MMR (monthly membership report) data with claims history, running both through a proprietary analysis pipeline — including algorithmic detection and AI-assisted review — to identify members whose ESRD status isn't reflected in what CMS is actually paying the plan. Each finding is validated manually, and we handle the correction process with providers (facilitating submission of CMS 2728 forms from proper providers). We work with MA plans between 5,000 and 50,000 members. No upfront cost — we're paid only on what we recover. Reach out to us at contact@clearcapitation.com