Close Risk Gaps for Better Quality Outcomes
Identify and Understand Your Risk
Leverage our risk analytics software and support services to identify risk adjustment factor (RAF) score gaps and prioritize resources.
Our web-based software analyzes risk scores based on specific adjustment hierarchical condition categories (HCCs) as defined by CMS.
Additionally, our analytic support and risk adjustment expertise interprets risk score trend data to create both a prospective and retrospective risk adjustment strategy.
Manage Error Reconciliation
Optimize encounters and claims data submission throughput with our data transformation and submission tools that support the entire cycle of data submission.
Receive and analyze data for requirements and pre-validation prior to submission.
You can streamline error prioritization, correction, adjustment, resubmission, and status tracking to minimize overall claims data risk.
Increase Member Engagement and HEDIS Scores
Enable member engagement with our strategic tools and services that facilitate communication, risk-gap closure, and monitor performance.
Our data-driven, omni-channel messaging educates and assists members with care compliance. These interventions drive members to resolve health gaps and improve outcomes, increasing trust, member retention, and risk-gap closure.
Additionally, quality performance reporting and analytics provide insights that drive performance improvements and HEDIS score increases.
Gain Visibility Into Medical Records
Take advantage of automated workflows, a national network of reviewers, and experienced clinical auditors to ensure complete medical record documentation as part of your risk adjustment strategy.
Access and easily manage a secure, web-based dashboard for your projects, supported by reviewers that must maintain a 95% accuracy rate.