Discover the pros and cons of AI-augmented risk adjustment and how tech + expertise drive results.

Staffing & Resource Augmentation

We provide experienced RCM, HIM, coding, and CDI professionals, onshore and offshore.

Staffing & Resource Augmentation

We provide experienced RCM, HIM, coding, and CDI professionals, onshore and offshore.

Staffing & Resource Augmentation

We provide experienced RCM, HIM, coding, and CDI professionals, onshore and offshore.

Staffing & Resource Augmentation

We provide experienced RCM, HIM, coding, and CDI professionals, onshore and offshore.

Value Based Care Model Revenue Optimization for Healthcare Organizations

Chirok Health helps healthcare organizations succeed in value-based care by aligning clinical documentation, quality reporting, and revenue workflows to what payers actually measure and reimburse.

Why Healthcare Organizations Need a Dedicated VBC Model Support?

Value-based care changes how revenue is earned, how risk is measured, and how quality is audited. That shift requires an operating model built specifically for value-based performance.

Revenue depends on outcomes over time

Revenue depends on outcomes over time

VBC revenue is earned across the full patient journey, not a single visit or claim.

Documentation controls risk and payment

Documentation controls risk and payment

Accurate diagnosis capture drives risk scores, incentives, and shared-savings revenue.

Quality scores determine reimbursement

Quality scores determine reimbursement

HEDIS, STAR, and gap closure directly impact bonuses and penalties.

Care teams and finance must stay aligned

Care teams and finance must stay aligned

Clinical actions and financial results must be tracked in the same performance model.

Payers validate VBC performance year-round

Payers validate VBC performance year-round

RADV and quality audits continuously review contract accuracy.

Value-Based Care Coding Services

Accurate, risk-aligned coding that protects quality scores, risk adjustment, and value-based reimbursement.

FFS-Aligned CPT & HCPCS Coding

Risk-Aligned Coding Accuracy

Codes reflect true patient complexity to support RAF scores and contract performance.

Diagnosis & Medical Necessity Validation

Quality-Driven Code Capture

Diagnosis and procedure codes support HEDIS, STAR, and gap-closure reporting.

Coding Quality & Audit Readiness

Audit-Ready Code Validation

Coding is continuously validated to reduce RADV, quality, and payer audit exposure.

Value-Based Care Clinical Documentation Integrity Services

Clinical documentation integrity ensures diagnoses, conditions, and care plans accurately support quality scores, risk models, and value-based reimbursement.

Quality Measure Abstraction

Quality Measure Abstraction

Clinical evidence tied to HEDIS, STAR, and care-gap closure is captured, validated, and prepared for compliant value-based reporting.

Risk & Retrospective Validation

Risk & Retrospective Validation

Patient records are reviewed to confirm diagnoses and conditions that support accurate risk scores and contract-level reimbursement.

Value-Based Care Revenue Cycle Management Services

Revenue cycle workflows aligned to value-based contracts, quality performance, and risk-based reimbursement models.

Demographic Registration

Accurate patient and payer data from the start

Prior Authorization

Payer-aligned approvals before care is delivered

Charge Capture

Every billable service recorded correctly

Edits & Rejections Management

Fix claim errors before submission

Denials Management

Recover and prevent denied claims

Payment Posting

Post payments quickly and accurately

Credit Balance Resolution

Identify and resolve overpayments

Insurance Follow-Up

Work unpaid claims to reduce AR

Correspondence & Appeals

Manage payer letters and appeals

Value-Based Care RCM Staff Augmentation

Dedicated Chirok Health specialists extend your value-based care revenue cycle, supporting risk, quality, and contract performance across your organization.

VBC Workflows Supported Across Any EHR

Chirok Health staff operate directly inside your EHR to support value-based care without disrupting existing workflows

EHR expertise for VBC

Who We Serve Under the Value-Based Care Model?

Our value-based care solutions support organizations responsible for population health, risk, quality performance, and contract-based reimbursement.

Medical Groups Support primary care and specialty groups managing risk adjustment, care gaps, and quality performance across value-based contracts.
Specialty Practices Ensure specialty-driven diagnoses, care pathways, and outcomes are accurately captured for VBC risk and quality programs.
Ambulatory & Outpatient Organizations Align ambulatory care delivery with HEDIS, utilization, and cost-of-care performance measures.
Hospitals & Health Systems Coordinate inpatient and outpatient documentation, quality reporting, and risk capture across system-wide value-based contracts.
Risk-Bearing Organizations Support ACOs, MSOs, and provider-led entities managing shared savings, downside risk, and payer performance targets.

Value-Based Care Compliance, Built for Performance

Chirok Health ensures risk scores, quality results, and contract revenue are supported by compliant, audit-ready value-based workflows.

HIPAA-compliant workflows

Clinically supported risk capture

Audit-ready documentation trails

Quality measures you can stand behind

Coding and billing compliance oversight

VBC-aligned coding and abstraction

Continuous Staff Training & QA

Continuous compliance assurance

Why Healthcare Organizations Choose Chirok Health for Value-Based Care?

Value-based care requires precision across quality, risk, and revenue. Chirok Health brings accountability to every part of the model.

Built specifically for value-based contracts

Built specifically for value-based contracts

Performance tied to contract outcomes

Performance tied to contract outcomes

Specialized Fee-for-Service Expertise

Human expertise supported by automation

Transparent Performance Metrics

Full transparency across VBC performance

Designed for long-term value-based growth

Designed for long-term value-based growth

Measurable Impact of Our Value-Based Care Optimization

What organizations achieve when clinical insight, risk validation, and human review work together.

1

Net New HCCs Identified per Patient

Previously undocumented risk conditions are identified and clinically validated to strengthen RAF accuracy.

1

Chronic Conditions Confirmed per Patient

Known conditions are consistently captured, supported, and aligned with value-based care requirements.

0 %

Acceptance Rate on Identified HCCs

Validated conditions meet payer and CMS standards for risk adjustment and audit review.

0 %

 Incremental Opportunity Beyond AI Outputs

Human clinical expertise identifies additional risk and quality opportunities missed by AI-only models.

Get in Touch

Let’s talk about your value-based care goals

Whether you’re managing shared-savings contracts, downside risk, or quality programs, our team is here to help you align care, documentation, and revenue.

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