Risk Adjustment Coding
Risk Adjustment Coding is an end-to-end risk adjustment and clinical coding solution for payers that need accurate supporting data from member medical records to help drive improved risk scores.
What’s included in Risk Adjustment Coding
Risk adjustment coding you can trust
- We have more than 20 years of experience in medical records retrieval, codding, and abstraction
- Ensure coding accuracy through clinical staff and quality control measures
- Scale to suit your needs with onshore and offshore offices
- Optimize reimbursement with AI and natural language processing coding technology
- Help accurately identify HCCs that are commonly missed or coded improperly in manual reviews
Fully integrated risk adjustment solution
- Retrieve medical records and perform clinical coding
- Integrate with Risk Advisor using smart analytics to help improve your score
- Utilize the same medical records to be abstracted for quality ratings for HEDIS® or Stars™
- Stay up to date on the status of the retrieval and coding
- Use Alert, a client portal that shows the status of chart retrievals in real time
- Allow payers to manage the process and communicate internally using Alert
- Portal includes a dashboard, key sites, member view, pends by site, and other key features
Software to help provideaccurate risk adjustment coding
Innovative technology to help increase review speed
Leverage AI and natural language processing technology to review a broader data set rapidly and thoroughly. This includes clinical evidence within the unstructured narrative of the medical record for better accuracy and more complete documentation.
A flexible workforce to achieve scalability
Risk Adjustment Coding allows you to engage a flexible workforce in scalable record retrieval through either our onshore or offshore offices.
Advanced software to help improve accuracy
Help improve accuracy and compliance of revenue with the industry's first end-to-end risk adjustment solution incorporating chart retrieval, analytics, coding, and submission. Risk Adjustment Coding helps you achieve high accuracy rates supported by clinical evidence and our rigorous quality control, helping to minimize audit risks.
Providing Measurable Value
charts coded annually for risk
audit pass rate
coders across our onshore and offshore offices
Need support for
- Retrieval as a Service Learn how our Retrieval as a Service Solution leverages digital connectivity to maximize retrieval yield while also decreasing turnaround time and provider burden. Learn more
- Medical Record Retrieval Discover our operational service for payers that need to retrieve medical records for risk adjustment and quality with scale and real-time transparency. Learn more
- Clinical Abstraction Discover how we can execute chart abstractions at various process levels to help payers optimize management of quality-related data for HEDIS and Stars. Learn more
Join Community discussions
Find and share knowledge, exchange ideas, and collaborate with peers and Change Healthcare experts to drive your solutions to success.