Persivia

  A risk adjustment solution calculates risk scores using HCC coding to predict healthcare future costs. The HCC framework was not intended to complicate the HCC coding procedure. Its objective, however, is to present a clear image of each member's accurate and full profile in order to better comprehend their health state and care costs. Beneficiaries allow for payment for care that has an impact on patient outcomes. Appropriate compensation is a win-win for all the organizations involved- the member, healthcare plan, and physician. Using HCC Coding alone in Risk Adjustment Solutions to improve HCC capture and re-capture rates is an expensive technique. With this in mind, many businesses are turning their attention to technology. This will assist them in determining which findings are under-coded or wrongly coded. It is frequently questioned in medical coding how HCC Coding Engine differentiates from Natural Language Processing or NLP. Although both NLP methods use technology t...

A Care Management Platform offers considerable advantages to an organization, such as increased patient, physician, and staff satisfaction, cost savings, and improvements in quality and safety. In recent times, healthcare organizations employ Care Management Solution that helps them with complex medical conditions. As healthcare moves away from fee-for-service to value-based payment models, such programs have become more important. When talking about care management the role of Care Management for Payers shouldn’t be skipped out. It is usually possible to classify payers into four categories: Health plans, payers, insurers and pay providers. The role of Care Management for Payers is critical to coordinating effective care. A payer care management program targets and engages specific types of patients in order to align costs with the outcomes of their members. In addition to transitions of care management, there are complex case management programs, chronic condition management prog...

Keeping track of clinical reporting is no easy feat. The fast-paced nature of running healthcare facilities makes it easy to overlook such clinical measures. Maintaining records of global happenings, accountability, and reporting all hospital, clinic, or private practice activities is crucial on all scales. The importance of Quality Reporting is incomparable.  The Quality Reporting System can assist the hospital management in correctly reporting procedures. Reliable reporting results help in proactive planning, development, and management analytics. It forging suitable Quality Reporting standards aids in retaining accountability. It also incorporates an evidence-based organizational framework for hospital facilities. Reporting is crucial for every level of hospital establishment. It provides a clear evidence-based overview of healthcare data. That improves the healthcare services at both hospital and national levels. What is Quality Reporting in Healthcare? The reporting pro...