Optimize Risk Adjustment for Enhanced Clinical Outcomes, Compliance, and Revenue Integrity
Drive revenue integrity and compliance across Medicare and individual lines of business with Access Healthcare's comprehensive Risk Adjustment Services.
Our end-to-end solutions are designed to identify and optimize risk adjustments, ensuring accurate and compliant compensation for your members' risk share. With a focus on coding and documentation improvement, HCC coding validation, chart reviews, member risk score analysis, provider education, forecasting of risk trends, and support for the Risk Adjustment Data Validation (RADV) process, we help you achieve better financial outcomes while maintaining regulatory compliance.
Access Healthcare’s Risk Adjustment Coding and Reporting Solution
Our Risk Adjustment Services Include:
Coding and Documentation Improvement: Our expert coding and documentation teams collaborate with healthcare providers to ensure accurate and complete capture of diagnoses. Through thorough chart reviews, documentation training, and ongoing support, we improve coding accuracy and optimize risk scores.
Hierarchical Condition Category (HCC) Coding Validation: Our HCC coding validation services ensure the accuracy and completeness of coding documentation. Leveraging advanced technology and expert auditors, we validate and reconcile codes, minimizing errors and maximizing risk adjustment accuracy.
Prospective and Retrospective Chart Reviews: Our comprehensive chart reviews identify missed or undocumented diagnoses. Through thorough analyses of medical records, we uncover opportunities for appropriate documentation and coding, leading to more accurate risk adjustment and optimal reimbursement.
Member Risk Score Analysis: With advanced analytics capabilities, we analyze member data and identify gaps in risk adjustment. Leveraging data-driven insights, we help health plans proactively address risk adjustment opportunities, improve financial performance, and enhance care coordination.
Forecasting of Risk Trends and Care Interventions: Through advanced analytics, we forecast risk trends and identify opportunities for targeted care interventions. This proactive approach enables you to implement effective strategies to improve health outcomes, enhance care coordination, and drive revenue integrity.
Support for Risk Adjustment Data Validation (RADV) Process: Our team provides comprehensive support throughout the RADV process, ensuring compliance with regulatory guidelines and minimizing audit risks. We assist in data validation, documentation review, and compliance with RADV requirements.
Our Value Proposition
Revenue Integrity: Our Risk Adjustment Services optimize risk scores, ensuring accurate compensation for the care provided and minimizing revenue leakage.
Compliance: We help you navigate regulatory requirements and maintain compliance with risk adjustment guidelines, minimizing audit risks and ensuring adherence to industry standards.
Financial Performance: By enhancing risk adjustment accuracy, we improve financial performance and maximize revenue potential for your health plan.
Care Coordination: Through member risk score analysis and forecasting of risk trends, we enable proactive care coordination, helping you identify and address member needs more effectively.
Provider Collaboration: Our provider education and training programs foster collaboration and empower healthcare providers to contribute to accurate risk adjustment and improved financial outcomes.
Partner with us
Partner with Access Healthcare to optimize your risk adjustment processes, drive revenue integrity, and achieve better financial outcomes. Contact us today to learn more about how our Risk Adjustment Services can benefit your health plan.