Set Up The Health Plan For Success Through Risk Adjustment

Health Insurance Companies can overcome the obstacles of Risk Adjustment (RA) and manage the process from Risk Adjustment Factor (RAF) to submission with a practical and up-to-date Risk Adjustment Solution.

Risk Adjustment Solutions for the healthcare industry come in a variety of combinations. On the other hand, a health insurance company should pick the correct Risk Adjustment Solution that can provide the pertinent tools to improve business intelligence, capture reflected but untraceable illnesses, explore clinical notes with the highest chance of granting incremental, and articulate the vast scale of the participating inhabitants. The most effective, adaptive, and customized technique centralizes Risk Adjustment activities, integrates analytics, and generates dashboards that appear and perform appropriately.

Such a RA Solution will enable the Health Plan to develop a deep understanding of each chart by adopting an integrated strategy to obtain a health file then and adequately then and adequately reuse the value of the data.

Risk Adjustment Solution That Works from Beginning to End

Health Plans want to ensure that the medical conditions stated in the medical files they receive are precise, constantly updated, and structured.

Health Insurance Companies can achieve the following objectives with a robust Risk Adjustment Solution:

1)   Impeccable beneficiary and health practitioner relationships

2)   Effective and reliable recovery of clinical information

3) Actionable insights of top standard, with access to deeper layers of a hierarchically organized database as professionals progress through the participant, provider, and promotion phases.

Methodical and Computational Data Analysis

A comprehensive detecting and intervention data analysis solution for risk and reliability that employs machine learning and predictive analytics to deliver insights about healthcare practitioner involvement, retrieving effectiveness, and record keeping compatibility.

Data Gathering and Processing

An efficient data gathering tool that leverages the extensive practitioner and EMR infrastructure to satisfy provider data needs. The retrieval mechanism is driven by the substantial health insurer familiarity, leading to more efficient data access and lower provider degradation.

Natural Language Processing (NLP) for Robust Charting

A game-changing software that allows companies to use Natural Language Processing (NLP) and machine learning algorithms to spin unstructured patient records data into accessible files and structured data. This enables Health Plans to capture ICD-10, HCC proactively, and HEDIS linked datasets and provide insightful highlights of demographic and medical characteristics.

Hierarchical Condition Categories HCCs Coding

A comprehensive set of HCC Coding and abstraction tools for Health Insurance Companies, including adequate mining for HEDIS and throughout the Risk Adjustment continuum, is strongly recommended.