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We looked inside some of the posts by medicaidriskadjustmentsolutio and here's what we found interesting.
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Right Medical Encoder Software
A system is only as good as its use. This is why you should look for medical encoding software that offers a user-friendly interface for coders and non-coders to navigate and interact with. This encourages teams to use the software and its variety of capabilities. Additionally, an intuitive UI helps streamline tasks and mitigates user errors. For more details visit https://www.slideshare.net/slideshow/right-medical-encoder-software/277118644
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RADV Audits
On May 14, 2024, the Centers for Medicare & Medicaid Services (CMS) published the 2022 Benefit Year HHS-RADV Results Memo, including Appendix A. This critical document provides an in-depth analysis of error rates, adjustments to risk adjustment state transfers, and other significant implications from the 2022 CMS RADV results. For more details visit https://www.episource.com/resources/top-10-highlights-from-the-2022-radv-results/
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Chart Audits Services
Episource specializes in reviewing charts previously coded by other vendors to enhance coding quality and accuracy. Our goal is to validate proper coding, identify coding without supporting documentation, and ensure that claims are substantiated by clinical data from the medical record. Additionally, we carefully review and capture newly identified codes according to industry guidelines. For more details visit our website https://www.episource.com/provider/chart-audits/
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Retrospective Review Service
Coding errors impact risk scores, reimbursements, and create incomplete or inaccurate medical records for your patients. You can fix those errors, however, with Episource’s Retrospective Review service. We will examine medical records after care has been delivered and claims have been submitted to identify any coding errors, giving you an opportunity to correct your submissions. For more details visit our website https://www.episource.com/provider/retrospective-review/
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Concurrent Review Service
In between the time your consult with a patient and a claim is adjudicated, you have a window of opportunity to double-check that all diagnoses have been correctly coded and documented. With Episource’s Concurrent Review service, you can take full advantage of this opportunity by having your codes and submissions independently verified and corrected. For more details visit https://www.episource.com/provider/concurrent-review/
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Bridging Clinical Documentation Improvement and Technology to Improve Patient Outcomes
Clinical documentation improvement (also called clinical documentation integrity) is the backbone of accurate patient records, ensuring that documentation reflects the full scope of a patient’s health status. This is crucial in risk adjustment, where documentation deficiencies can lead to inaccurate reporting of patient conditions affecting both patient care and reimbursements. For more details visit https://www.slideshare.net/slideshow/bridging-clinical-documentation-improvement-and-technology-to-improve-patient-outcomes/275889758
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Direct EMR
Connecting to every EHR and mapping the data from different formats can be a complex and time-consuming process for providers. But with our Direct EMR service, we can simplify this process for you. Our interoperability solution, Episource Hub, streamlines data exchange by providing a chase list detailing specific data requirements. We then send this chase list to one of our trusted EMR integration vendors, who efficiently retrieves charts, ensuring accuracy and speed in data acquisition. Say goodbye to the hassle of manual data mapping and let us handle the heavy lifting for you. Focus on delivering quality patient care while we take care of your data integration needs. For more details visit our website https://www.episource.com/provider/direct-emr/
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Remote Automation
Performing remote chart retrieval manually can be a cumbersome task, consuming valuable time, effort, and increasing provider burnout. The process of logging in, searching, and downloading charts can extend for days or even weeks, particularly with larger chases. Moreover, meeting tight deadlines may require the involvement of multiple team members, adding unwanted complexity to the process. To solve these challenges, we developed a Remote Automation service that eliminates the inefficiencies of manual retrieval. Our streamlined solution simplifies and accelerates chart retrieval, ensuring that you meet deadlines with ease and efficiency. For more details visit our website https://www.episource.com/provider/remote-automation/
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Medical Records Retrieval
Episource has perfected the Medical Records Retrieval process with a repeatable and scalable approach that has been proven to yield results. We combine data-driven insights with our own site-specific experience that optimizes workflows and builds out custom solutions for your specific requirements. Allow us to track down the records you need to provide the best care to your patients. For more information visit our website https://www.episource.com/provider/medical-record-retrieval/
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Medicare Advantage Risk Adjustment
The law of the jungle known as “survival of the fittest” was a prevalent theme in the health insurance market in the twentieth century. Prior to 1997, some health plans would hand-pick the population’s healthiest members so that they wouldn’t have to assume significant risk. As a result, people with poor health who were likely to incur substantial medical costs had a difficult time getting insurance coverage. Hence, risk adjustment arose as a solution to improve the overall health of the U.S. population. Risk adjustment gives health plans the necessary incentives to enroll beneficiaries with a variety of health problems — from those who are generally healthy to those who have several chronic disorders. For more information visit https://www.episource.com/resources/the-evolution-of-risk-adjustment-and-medicare-advantage/
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Top Risk Adjustment Tools Every Healthcare Plan Should Know
Risk adjustment tools are critical for healthcare plans, as they help estimate the cost of treating a patient in a given year, based on their specific health needs. This helps ensure that health plans are compensated appropriately — creating a weighted system for those who require more or more costly services. Additionally, this enables the providers to treat patients with different needs and not just healthier, less costly patients. Here are some of the top risk adjustment tools healthcare plans should have at the ready. For more information visit https://www.slideserve.com/George125/top-risk-adjustment-tools-every-healthcare-plan-should-know
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Episource Hub
Episource Hub is an interoperability solution designed to provide ACOs, DCEs, and large provider groups with electronic access to up-to-date healthcare data whenever you need it. With this data, we unlock actionable insights that will help you plan outreach and interventions for patients, improve quality of care, and also manage costs. Experience the Episource Hub difference. For more information visit https://www.episource.com/provider/hub/
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Episource Analyst
Episource Analyst is an essential tool for Medicare Advantage and Medicaid provider organizations in risk-based agreements. Its advanced analytics and recommendations can be used to accurately assess the health risks of your patient population. More importantly, this information can also be used to execute earlier interventions for your patients. Find all the analytics you need quickly and efficiently. For more information visit here: https://www.episource.com/provider/analyst/
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Risk Adjustment Program Assessment
Understanding risk adjustment data can be challenging, and standard technology solutions are often one-size-fits-all. That’s why we’ve created a solution that combines the technology and expert teams you need to unlock clinically relevant insights specific to your patient population. We start with the full power of our analytics technology, and then apply the deep subject matter expertise of our risk adjustment team to provide a 360º view of your risk adjustment program performance — where it is today, what’s working, and what isn’t. For more information visit here: https://www.episource.com/provider/risk-adjustment-program-assessment/
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Risk Adjustment Audits
Effective risk adjustment is pivotal to ensure fair and adequate compensation for health plans, as well as to guarantee that beneficiaries are enrolled in plans that suit their specific healthcare needs. Compliance plays a crucial role in minimizing payment errors, fostering a more effective, transparent, and equitable healthcare system. By adhering to the compliance protocols during risk adjustment audits, healthcare providers can significantly enhance their service delivery and overall operational efficiency. For more information visit https://www.episource.com/resources/the-cost-of-non-compliance-an-overview-of-risk-adjustment-audits/
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Extracting Value-Based Care Insights from Claims Data
In healthcare, value-based care (VBC) is becoming the foundation for improving patient outcomes while managing costs. Though providers bear much of the responsibility for implementing VBC principles, health plan involvement is essential to achieving sustainable, system-wide improvements to support VBC programs. Payers can significantly influence the success of value-based care initiatives through innovative payment models, claims data sharing, and enhanced support for patient management. For more information visit https://www.pinterest.com/pin/914723374316953989
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Maintaining a Robust Data Collection Process for Risk Adjustment Compliance
Risk adjustment accounts for patient health status, demographics, and clinical conditions to balance healthcare costs and evaluate outcomes accurately. Faulty or incomplete data can distort these evaluations, leading to improper resource allocation or risk adjustment compliance risks. A well-structured data collection process ensures not only adherence to regulatory requirements but also the delivery of equitable care to patients. For example, a patient with multiple chronic conditions may receive insufficient care due to incomplete documentation of their medical history. Improved data collection practices could have prevented this outcome. For more information visit https://www.slideshare.net/slideshow/maintaining-a-robust-data-collection-process-for-risk-adjustment-compliance/274457199
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