iCode Risk Adjustment

 

GeBBS’ iCode platform is an intelligent workflow tool that helps payers perform risk adjustment and HEDIS initiatives utilizing a self-service tool. With real-time dynamic reporting, actionable data, and full transparency, our risk adjustment technology streamlines the workflow, improves productivity and quality for Government payers and risk bearing providers. Our technology addresses critical pain points for payers with its chart retrieval feature, concurrent review capabilities, and ability to capture HEDIS and STAR measures.

GeBBS Risk Adjustment Workflow Features:

  • Provider Scheduling: Gain efficiencies with chart retrieval scheduling using our proprietary platform, which allows for special handling requirements and identifying key sites as well as active engagement in resolving irretrievable charts. Utilizing GeBBS’ provider database, you can ensure you have correct provider information for faster and accurate provider information year over year.
  • Chart Retrieval: iCode proprietary technology and provider-sensitive processes support greater engagement and satisfaction among providers. Chart recovery methods offer providers a lot of flexibility and reduce provider abrasion. They are HIPAA-compliant, tested, and secure; provider portals with drag and drop capability, EMR integration and EMR CCD data exchange along with onsite retrieval, fax, mail. Our unique dashboard provides full transparency into real-time chart retrieval status and allows you to make decision during the critical times in the process.

HCC Coding – Within each review, we support your organization’s efforts to capture all risk adjusted diagnoses and ensure members are appropriately risk-adjusted. Our fully employed team of over 2,000 coders can scale quickly and complete projects of any size. We offer a full-service coding solution for all risk-adjustment coding: ACA-Commercial, Medicare Advantage, and Managed Medicaid. Our compliance-based approach to medical record coding is delivered by AAPC or AHIMA certified coders who capture or suggest deletion of risk adjusting diagnostic codes and can also perform data validation audits. GeBBS coders are trained to identify conditions for provider education that do not meet CMS criteria based on documentation. This information is packaged in actionable reports.

  • Data Validation – Confirm the accuracy of existing diagnosis data from health plan or provider documentation. Identify risk adjusted conditions that were not previously submitted. Use customized data to facilitate multiple audits and reviews. Compare what was found from blind coding to claims data and suspecting analytics.
  • Quality Review Processes – Assure the highest standards of coding quality, with ongoing quality checks occurring throughout the life cycle of your projects. Our system allows the client to receive quality reporting and/or access to the system to perform quality checks themselves.
  • Client Portal – Leverage a web-based interactive client portal for real-time transparency into project progress and obtain views of operational data at each stage of the project, including provider participation, clinical review progress, quality reviews, ability to conduct coding over reads, download chart images and generate reports.
  • Provider Education
  • HEDIS

Additional Resources:

Webinar: RISE Health Association – Risk Adjustment Strategies Between Payers and Providers: Real Life Tactical Examples from Industry Leaders

In this Panel Webinar, industry leaders from both sides will present the audience with specific risk strategies between payers and providers.

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Case Study: Second Level Review Gives You The Peace of Mind That You Are Ready for RADVs

GeBBS Healthcare Solutions applies insights to encounter details that lead to appropriate risk scores and ensures compliance.

Download Now

Tyler Cowart | June 14, 2019