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Jun 11, 2019

Time to commit to reconciliation of your encounter data submissions

Your health plan’s encounter submission processes are in place with files getting submitted like clockwork, so you can sit back and relax, right? No! More than 80% of revenue for a typical Medicare Advantage (MA) health plan is risk-adjusted revenue, and if you aren’t continuously evaluating and reconciling encounter submission and response files, you could be missing out on millions of dollars in annual revenue.

Oct 22, 2018

Do you have a comprehensive and effective risk adjustment program?

Many health plans focus on sweep dates and code capture while working in some prospective outreach for members, but are you optimizing your Risk Adjustment (RA) activities and tools to improve coding documentation and data submissions throughout the entire year? If not, you should be!

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