Brian Allen

Brian has 15 years of experience working with provider contracting, market reimbursement analysis, and building software solutions. He has extensive experience repricing detailed claims level data to Medicare and other contract bases and performing related reimbursement analysis. He has worked with commercial health plans, health maintenance organizations, health insurance carriers, and provider organizations on projects, such as evaluating provider reimbursement and performing detailed claims data analyses, including commercial contract evaluation and repricing, Medicare and Medicaid schedule repricing and benchmarking, rate guarantee valuation, and parity audit analysis. Brian is a project lead for the Department of Veteran’s Affairs Medicare pricing auditing evaluation to support validation of VA’s Medicare claims repricing using the Medicare Reference Pricer. He is also the technology lead for the Medicare Reference Pricer product.

Brian also has experience in several other areas of healthcare analysis and consulting, with projects related to:

• Provider reimbursement benchmarking and contracting strategy
• Risk adjustment for population benchmarking and government risk-based payment programs
• Pricing and rate development
• Medicare Advantage bid preparation
• Claims mapping and categorization
• Claims repricings
• Analysis of actuarial liabilities
• Software development and data analysis