Providers are the source for care, quality, compliance, and risk adjustment documentation. Our solutions assist physician groups, Accountable Care Organizations (ACO), Independent Physician Associations (IPA), and Management Services Organizations (MSO) in improving their clinical coding accuracy and specificity. Our services enhance each provider’s ability to perform data aggregation, as well as manage their quality and risk adjustment strategies. Having insight into risk adjustment and the patients’ health status creates the opportunity for improvements in the quality of care for members—which has an impact on financial outcomes.
By RaeAnn Grossman We all thought commercial with concurrent review, IVA, SVA, claims validation and EDGE server demands was tough, but Medicare Advantage risk adjustment with quality and care integration is moving just as fast and the data demands are more challenging than ever before. The strategies are shifting, regulations are changes, timing is expedited, […]
By RaeAnn Grossman Yesterday Jonas Foit and I conducted a webinar on the virtues of insightful analytics coupled with a deep diving BI tool. BI tools are great for many reasons, here are a few: Highlighting program and project impact Illuminating strategic successes and efficiencies Bring to the surface tactical alerts and warnings Compiling member […]