Risk Adjustment – Second Level Review: HHS-HCC score increased from 3.89 to 4.4 across ACA members

Client Background and Context National Health Plan with 3.5M+ members. The Fortune 500 client found gaps in their coding & claims data collection/submission process for a subset of their ACA…

Continue ReadingRisk Adjustment – Second Level Review: HHS-HCC score increased from 3.89 to 4.4 across ACA members

Internal Data & Audit Platform: 30% increase in productivity & 50% reduction in technology spend

Client Background and Context Client with 20+ risk-bearing locations & various data input sources wanted to: Partner with a platform to audit codes received from multiple sourcesImprove productivity of each of…

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