Optimize reimbursement and risk accuracy by identifying unreported and under-reported risk-adjusted conditions
Gain valuable understanding and data insights to benchmark, compare, and assess overall risk at the health plan, provider, group, and member levels.
Dynamic dashboards provide actionable insights for risk adjustment to identify and compare risk adjustment revenue, risk adjustment scores, and address gap closure opportunities.
Analytics informs users of paid, accrued and projected Risk Adjustment Factor scores, HCC drop-offs, historical RAF score comparisons, and suspected HCC conditions.
Benchmark various capacities: year-over-year, year-to-date, and month-over-month.
Analysis at the provider level ensures the prioritization of membership, maximizing revenue by recapturing existing HCCs, and identifying/capturing new HCCs.
Delivers standard reporting sets driven by contract parameters, payment methodology, and configuration of value-based care performance tracking.