Payer Solutions Drive Risk Adjustment Improvement
Our payer solutions allow both government payers and risk-bearing providers to improve their risk adjustment and quality initiatives. Using a single enterprise platform, we deliver intuitive, comprehensive solutions that improve productivity, increase accuracy, and provide real-time analytic reporting and control.
Improve Risk Adjustment With the Right Technology and Resources
GeBBS is one of the leading HCC coding companies. Our proprietary technology-enabled platform provides flexibility to choose the services you need to be successful. The GeBBS risk assessment dashboard illustrates the impact of different diagnoses on the total Risk Adjustment Factor (RAF) score in real-time and includes recommendations for improvement. We provide some of the highest results around risk adjustment coding, HEDIS abstraction, and retrieval.
2000+
Coders for any scale of projects
Proprietary Technology Optimizes Risk Adjustment
Ready to talk? Activate for better healthcare
- Chart Acquisition
Our Chart Acquisition platform is data-driven to reduce overall acquisition cost. Our acquisition call center resources are white-labeled and easily customized, allowing clients flexibility for their business needs. The client-centered platform is highly secure and provides an integrated solution where the payer can drive priorities, timing, approach, and track performance across multiple retrieval needs. Using our platform, healthcare organizations can receive charts directly from providers – quickly, automatically, and cost-effectively.
Enterprise coding solution
-
40%
-
30%
Easy to use provider portal reduces provider abrasion
Chart data searchable by provider, member, disease category/diagnosis and keywords to prioritize actions from retrieval through chart review
Multiple modality retrieval options to increase the likelihood of success with providers
Single performance management dashboard for real-time insight on project status, non-participating management and payment processing
Customized provider packets, multiple retrieval mechanism options like provider portal/scantech portal, ability to schedule and track field tech actions
IMPACT
25%
additional cost RA Codes added
Enterprise coding solution
-
95%
-
98%
Identify gaps to improve quality through searchable chart repository
Produce real-time compliance reporting by measure
Perform risk adjustment and monitor quality simultaneously
IMPACT
20%
Increase in reimbursements based on new RAF calculations for clients
GeBBS’ risk adjustment payer analytics are backed by powerful technology-driven processing that integrates Natural Language Processing (NLP) solutions, robust data validation, and QA initiatives. This workflow empowers efficiency with real-time targeted diagnoses and actionable datasets. Our completely customizable solutions can be tailored for second and third-level reviews, blind coding, claims data validation, and QA scrutiny.
Enterprise coding solution
98%
data captured on 1st pass
25%
additional cost RA Codes added
Layered solutions to ensure completeness and accuracy of coding data
Complete client transparency with access to all data and analytics
Reports captured which provide analytical insights on revenue variance and error trending
Analytical dashboards and real time reporting
IMPACT
30–40%
cost savings with less need for review
Enterprise coding solution
-
0.75%
-
20%
Highest standards of coding quality with ongoing quality checks occurring throughout the life cycle of projects
Real-time RAF reporting to help payers extract appropriate compensation and avoid sizable penalties
Confirmed accuracy of existing diagnosis data and identification of risk-adjusted conditions that were not previously submitted
A web-based interactive client portal for real-time transparency into project progress and the ability to view operational data at each stage of the project
Two level audit workflow
IMPACT
$1.2M
Revenue opportunity captured for 13 Clients
Continuing provider education and training can significantly impact your revenue cycle by minimizing errors and staying on top of compliance and audits. Our provider education platform gives a comprehensive view to identify opportunities for provider education and feedback. It also allows you to review trending reports and education by provider, specialty, or HCC category. Our customizable education dashboard helps you and providers benchmark performance against other healthcare plans, groups, and peers. Moreover, our coders help identify processes and conditions that do not meet CMS criteria based on documentation.
Enterprise coding solution
0.75%
Average increase in RAF scores
18%
Increased HCC identified in Level 2 review
Real-time pre-bill provider query for live training and education on actual medical chart review
Retrospective reviews leveraging the end-to-end integrated platform
Better coding to improved cash flow for risk-bearing providers
Improved documentation at point-of-care reducing payer review costs
- Patient Access Management
IMPACT
24x7
Expanded hours coverage
Risk adjustment factor (RAF) scores help to get accurate provider diagnosis documentation. RAF scores are calculated by applying the HCC model to a beneficiary, taking into consideration their health condition, symptoms, and demographics. GeBBS’ RAF score reporting dashboard gives you a consolidated view of your plan, group, or individual member’s score. You can also see, in real-time, how the addition or deletion of different diagnoses affects the RAF score. In addition, we also provide suggestions on documentation and provider education to improve a particular RAF score.
Enterprise coding solution
0.75
Average increase in RAF score
20%
Increase in reimbursements based on new RAF calculations for clients
Artificial Intelligence and Cognitive Analytics Engine (iCAE) to improve the RAF score
Real-time dashboard for insights on RAF score for better decision-making and executive reporting
Concurrent and retrospective chart review options to improve RAF scores and documentation
Improved code capture for better RAF score accuracy for achieving ROI
IMPACT
25%
additional cost RA Codes added
GeBBS is your risk adjustment coding company. Know more about our latest insights, products and technological advancements in Risk Adjustment Solutions.
Impact Delivered by Risk Adjustment HCC Coding Solutions
Insights
Fortifying Your Healthcare Revenue Cycle Management Against Cyberthreats
The increasing frequency threat of cyberattacks impacted a significant number of healthcare facilities. These attacks complicated healthcare