As a leading provider of risk adjustment services, we offer comprehensive solutions tailored to meet the unique needs of health plans, provider
groups, ACOs, and other healthcare entities. Our vendor perspective encompasses a range of services designed to optimize revenue, reduce
administrative costs, and enhance overall performance.

Retrospective Risk Adjustment: Our retrospective risk adjustment solutions leverage logic-driven clinical algorithms to identify and validate
incomplete or inaccurate claims data through meticulous medical record data reviews. By uncovering valuable diagnosis codes not originally
submitted, we empower plans to maximize revenue potential while ensuring accurate risk assessment.

Concurrent & Prospective Risk Adjustment: With our concurrent and prospective risk adjustment services, we proactively identify gaps in care,
assessment, and provider documentation using advanced data analytics. By equipping providers with actionable insights before patient encounters,
we facilitate improved risk score accuracy and streamlined documentation processes, ultimately enhancing efficiency and reducing administrative
burden.

Data Aggregation and Submission Support: We offer comprehensive support for data aggregation and submission, including seamless
integration with EMR systems for enhanced data analytics and regulatory compliance. Our expertise enables us to identify potential coding
discrepancies and facilitate accurate submissions, thereby mitigating audit risks and ensuring regulatory compliance.

Natural Language Processing (NLP): Our innovative NLP technology accelerates and streamlines risk adjustment coding efforts by leveraging
machine learning algorithms to analyze large volumes of medical records. By optimizing the skills of professional coders and prioritizing coding
opportunities based on HCC potential, we enhance accuracy and efficiency in coding processes.

We provide specialized HEDIS chart review and abstraction services in accordance with the NCQA guidelines. With rigorous quality assurance, we deliver timely, precise data with 95%+ accuracy.

HEDIS domains and measures support achieving

Effectiveness of Care

Access/Availability of Care

Experience of Care

Utilization and Risk Adjustment Utilization

Health Plan Descriptive Information

Measures Collected Using Electronic Clinical Data Systems

We optimize every touchpoint to maximize member satisfaction and empower payers to enhance retention. We are committed to driving loyalty through member delight while allowing payers to scale and boost revenue.

We reduce communication gaps through timely query resolution and administrative support driving enhanced access, improved adherence and resource optimization.