Medicare Advantage Risk Score Verification
Service ensures the accuracy and integrity of risk scores. By thoroughly validating and verifying risk adjustment data, this service helps Medicare Advantage plans maintain compliance and optimize financial performance. It provides detailed insights into data quality, identifies discrepancies, and supports corrective actions to enhance overall program effectiveness.
Rapid Risk Adjustment Assessment
Service offers a swift and comprehensive evaluation of risk adjustment processes. This service identifies areas for improvement, ensuring accurate and compliant risk scores. It provides actionable insights to optimize risk adjustment strategies, enhance data quality, and improve overall financial performance.
Prospective Risk Adjustment Suspecting
Service helps organizations proactively identify and address risk adjustment opportunities. This service uses advanced analytics to pinpoint potential risk factors, enabling early intervention and accurate documentation. By focusing on prospective data, it supports effective risk adjustment strategies and enhances overall program performance.
FHIR Drill Acceleration Program
Helps organizations navigate the complexities of FHIR adoption, enabling them to start small and scale efficiently. It offers support in data extraction, validation, integration, and ROI evaluation, all while ensuring minimal technical overhead. This service guides organizations through their first bulk data requests and simplifies the use of CQL and SNOMED codes for quality improvement and risk adjustment.
Risk Score Accuracy
This service ensures the precision and reliability of risk scores used in risk adjustment programs. It thoroughly validates and audits risk adjustment data identifies discrepancies and implements corrective measures. By maintaining high data accuracy, it supports compliance and optimizes financial outcomes for health plans.
OIG Audit Exposure Accelerator
Program helps organizations proactively manage and mitigate risks related to Office of Inspector General (OIG) audits. This service offers a thorough assessment of audit readiness, identifies potential vulnerabilities, and provides actionable strategies to ensure compliance and minimize audit exposure. By leveraging expert insights, organizations can strengthen their risk management processes and safeguard against regulatory challenges.