Worried that missing or inaccurate data is impacting not only outcomes but also your bottom line?
DataLink provides in-depth medical chart reviews to support risk adjustment and HEDIS quality performance, compliance with the model of care, and improvement with clinical documentation and accurate coding.
Our team of registered nurses and certified coders conduct year-round reviews with extensive data analysis and education to assist with performance improvement for your at-risk or value-based care relationships.
Prospective Chart Review
Prepares medical record and providers to assess all acute and chronic clinical conditions that must be addressed during a subsequent face-to-face encounter for the Risk Adjustment Model of Care and fulfillment of HEDIS and quality measures
Enables the provider to conduct a comprehensive physical assessment at time of care
Facilitates proper medical record documentation of active and valid risk adjusted clinical conditions
Concurrent
Chart Review
Ensures accurate coding of the medical record for the date of service prior to encounter processing
Allows for provider education prior to encounter submission, supporting ongoing performance improvement
Decreases compliance issues and submission of invalid or erroneous codes that will require deletion
Facilitates accurate medical record documentation, provides specificity in code assignment, and improves risk score calculation, revenue reimbursement, and accurate reporting of HEDIS and quality measures
Retrospective
Chart Review
Recovers and validates CMS and RX HCCs
Identifies missed opportunities, lost chronic clinical conditions, and generation of suspect conditions
Recommends ICD-10 code deletion for diagnoses that aren’t supported, invalid, or are erroneous in nature via bi-directional review process
Provider education is offered at the specific encounter level for primary care physicians regarding documentation and compliance
Applicable specialists are included with this review based on our proprietary analysis and development of an external chart review target
Review is conducted as a one-year look back period
Specialist
Chart Review
Targeted chart chase using our proprietary algorithms to identify areas where revenue may be recovered based on the Risk Adjustment Model of Care
Medical records are retrieved via one of our various methods
Recovers valid and supported CMS and RX HCC clinical conditions, which are coded to the highest specificity supported in the medical record documentation
Facilitates the identification of new clinical conditions and proper HCC assignment
Includes a one-year look back period