Payer and provider centric solutions in Risk adjustment
Solution Description:
Achieving accurate risk score for enrolled patients by provider education.
Rectify it when it happened approach in concurrent coding. This helps in identifying chronic conditions early on and helps provider to document it in the upcoming visits.
Problem at hand
Poor Documentation
HCC conditions are skipped / under coded
Our Value Proposition
Concurrent HCC coding and identification of ICDs during E&M coding.
Query/educate provider on vaguely documented/suspected HCC conditions
Improving NLP effectiveness by suspect analysis.
Business Benefits
Payer compensation increase by ~ 15%
Improved Patient Experience
Improved provider ratings and reduced validation rejections
US based Healthcare Analytics and Services MNC
Solution Description:
Conducted intense domain training and now operates a team of 50+ outreach consultant supporting multiple clients across time zones.
Problem at hand
The requirement was to strengthen the team’s delivery footprint across the globe and set up its first Provider Outreach center in India.
Our Value Proposition
We worked with US and India’s leadership team to co-design and set up a pilot batch in 4 weeks.
Business Benefits
40% cost advantage from current offshore center Scaled up to support 15+ without ever missing a KPI and at a cost/chart of $1.5, allowing client to go after a bigger market share
US based Healthcare Analytics & Services MNCS based Healthcare
Solution Description:
We have developed a structured, streamlined, cost-effective, technology-driven solution to address all client’s Medical Record Retrieval challenges, increasing overall business efficiency.
Problem at hand
The requirement was to make more and more productive calls more in order to meet the SLA, major obstacles were to connect with the correct facility, submit formal request for MRR and get as much medical records as we can.
Our Value Proposition
Our experts have painstakingly developed a time-tested , foolproof method of speedy and effective communication with medical records custodians at hospitals, clinics and physicians’ offices.
Dramatically expedites the entire medical records retrieval process, ensuring quick turnaround times without compromising accuracy.
Business Benefits
In spite of all the obstacles there are several projects like Blue Shield of California, Village MD, Risk adjustment Validation project, on which our team performed exceptionally well
Met all the client expectations (SLA) also retrieved 100% medical records.