Payors: Risk Management Solutions
Audit services to help payors manage risk adjustment cost-efficiently and compliantly.
We understand the challenges you are facing
HCC Proficiency
Provider networks exhibit varying HCC coding proficiency with limited improvement support.
Compliance & Readiness
Upholding high compliance and RADV audit readiness.
Record Retrieval
Ensuring efficient record retrieval processes for audit documentation.
EHR Access
Limited access to provider EHRs hinders retrieval of medical records at the point of care.
Provider Relationships
Historical zero-sum dynamics can create tense and unproductive provider relationships.
See How We Help:
Provider Support
Supporting network providers to enhance adoption of risk adjustment documentation and coding standards.
Audit Services
Conducting audits to assess regulatory adherence and identify risk areas.
Chart Retrieval
Implementing workflows for complete and accurate documentation records.
Retrospective Review
Ensuring accurate risk scores before filing deadlines through retrospective reviews.
Collaborative Solutions
Working directly with providers to improve documentation and shift payor-provider engagement from a zero-sum mentality.
Driving results for traditional,
Fee-For-Service organizations