Risk Adjustment

We provide solutions that include Risk Adjustment (Medical Record Retrieval, Medical Record Coding, Analytics, and RAPS/EDPS Submissions), HEDIS®, and Stars Quality Program Management.

Our HCC coding services identifies care gaps and missed HCC opportunities during the retrospective review process to optimize your operational efficiencies. Highly effective coding review teams utilize CPC® and CRC® certified coders to assess diagnostics, health history, medication lists, treatment plans, imaging reports, and additional clinical documentation to capture all HCC diagnoses

Our retrospective risk adjustment services:

• HCC capture
• HCC adds/edits/deletions
• Precise RAPS/EDS submission
• Map clinical documentation gaps
• Optimal and accurate reimbursement
• Educate physicians with insightful analytics and live examples
• Clinical Documentation Improvement (CDI)
• HEDIS review
• Chart retrieval