Our turn-key software provides remote management of your Medicare Advantage operations.

Dynamic Healthcare Systems

Dynamic Healthcare Systems provides a comprehensive solution for health plans and provider groups participating in Medicare Advantage, Managed Medicaid, and Marketplace programs.  Headquartered in Santa Ana, California, the company offers comprehensive software solutions, managed services, and professional services.  Based on an intimate knowledge of Medicare policy, procedure and regulation, we offer our clients cutting edge technology solutions for the complex and ever-changing government sponsored healthcare marketplace.

Integrated Solution

Having a fully integrated system enables the automation of processes, real-time enrollment eligibility verification, and the ability to leverage work queues. These capabilities assist health plans with meeting CMS deadlines and detecting revenue issues and other potential discrepancies with CMS.  Synchronization found with Dynamic’s end-to-end solution eliminates the need for a multi-vendor approach.

Risk Adjustment

Dynamic has always been forward thinking and the forerunner in the industry for Risk Adjustment. Dynamic’s solution is built with the ability to adapt to ever changing CMS and industry requirements for RAPS and EDPS.  Dynamic’s RAPS, EDPS, HCC, and Analytics solutions deliver high CMS acceptance rates resulting in a lower risk audits.

Financial Solutions

Reconciling your monthly payments from the government is complex without this tool.  Dynamic’s Revenue Reconciliation solution simplifies and automates this process and will assist the plan verifying its monthly payments and, in the appeals, process of disputed payments. Dynamic’s Premium Billing solution provides health plans with a single, detailed source to manage billing activity for individual and employer-sponsored payments and Low-Income Subsidies.

Professional Services

Evaluate your programs and expand your knowledge of the current tactics, processes and policies for Risk Adjustment.  Our review includes internal processes, oversight of vendors for analytics or coding, data flows, and CMS compliance.   As well Provider programs , prospective program designs and management of implemented Risk Adjustment KPIs.

Marketplace Solutions

Solutions include EDGE Server, Advance Premium Tax Credits (APTC) and Cost Sharing Reduction (CSR). Be compliant with CMS’ distributed data collection process to submit risk adjustment data to support the “Three R’s” and provide analytics to review population patterns and health risk scores.

Revenue Optimization

Dynamic’s solutions help optimize revenue and quality through the utilization of Dynamic’s rich analytics that identify areas for potential improvement, help maintain compliance through ongoing enhancements aligned with CMS regulations, and enhance operational efficiency through fully integrated solution utilizing a centralized database and integrated workflows.


Dynamic is pleased to sponsor the following organizations:

Health Plan Alliance