RiskAnalyzer: Optimize Payment Accuracy for HCC Coding

Accurate Risk Adjustment is critical for appropriate reimbursement levels. Due to the aggregate impact of risk adjustment on health plan populations, failure to collect accurate data puts plans at significant risk of generating insufficient revenue to provide high-quality care to their member populations.

Our solution uses claims and clinical data to determine where provider coding is not appropriately and consistently capturing chronic disease conditions under the CMS-HCC and HHS-HCC models. Using an innovative HCC coding analysis, RiskAnalyzer allows you to identify medical records for retrospective chart review and identify those members who will benefit the most from prospective interventions, thus ensuring the highest quality of care.