Risk Adjustment

Why GeBBS?

  • U.S.-based company
  • Multiple global delivery centers in three countries
    • U.S
    • India
    • Manila
  • U.S.-based oversight and implementations

GeBBS provides a rightshore Payer BPO model for population health, risk adjustment, revenue management, and clinical review. Thorough and careful Medicare and Medicaid risk adjustments are critical to accurately capturing the health status of the beneficiaries, so resources can be appropriately allocated to treat and manage care. GeBBS is committed to collecting every relevant medical record, coding each one correctly and delivering reliable, accurate results for use in risk adjustments. We are a U.S.-based company with multiple global delivery in three countries. We can provide scalability, increase quality, and reduce costs with all oversight and implementations done in the U.S. Partner with GeBBS for all your Medicare and Medicaid risk adjustment needs.

Payer Solutions

GeBBS offers a number of solutions including:

Risk Adjustment

  • Medical record review
  • Secondary audits & overread
  • Provider education & support

Quality and Compliance

  • Medical record abstraction
  • Telephonic outreach & scheduling
    • Member satisfaction surveys
    • MOC STARS member surveys
    • Interventions/gap closure
    • Medication reconciliation

Case and Care Management

  • Telephonic health risk assessments and surveys
  • Care coordination and scheduling (network steerage)
  • Medication reconciliation and adherence
  • Pre-Authorization management

Utilization Management

  • Concurrent review for medical appropriateness
  • Retrospective review for quality assurance
  • Prior Authorization/Pre-Certification management
  • Medical necessity/level of care review programs
  • Appeals & Grievances – data intake, administrative & tier 1 medical review

Post Utilization Solutions

  • Audit
  • DRG
  • Coding review
  • Claims management
  • Appeals management

News Release | April 21, 2017