Cirdan Health Systems and Consulting

Actuarial and Data Services

Cirdan Health Systems and Consulting

Cirdan is an actuarial and data services company specializing in not-for-profit, safety net health plans serving Medicaid and Medicare. Cirdan’s staff includes credentialed actuaries, consultants, and data services professionals. Cirdan understands the unique actuarial, data, and financial management challenges and opportunities facing health plans serving public programs.

Actuarial services include reserve analysis and certification, premium rate analysis and negotiation support for Medicaid contracts, financial evaluation of new programs and benefits, assessment of reinsurance needs, medical expense evaluation, and Medicare bid development. Cirdan also provides clients CFO and financial department services, including NAIC financial reporting. These high-trust roles give the firm a unique insider’s perspective.

Cirdan excels at managing Medicare and Medicaid encounter data through a highly-effective business process outsourcing model grounded in health plan operations. We supplement health plan internal capacities and also provide support for plans that prefer to fully out-source the required regulatory submission process. We provide analytics and oversight of Medicaid encounter data and Medicare EDPS and RAPS files. Our Encounter Analysis and Oversight Tool and dashboards allow users to review both current status and trends for critical metrics such as error trends and unresolved backlog, revenue lost from missing diagnoses, and current submission status of all claim batches. Cirdan also helps clients increase risk adjustment score accuracy for both Medicare and Medicaid members.

John Klein, Principal

Nancy Nelson, Principal

444 Cedar Street, Suite 500
St. Paul, MN  55101
(Work) 651-228-9891
(Fax) 651-228-9893