Choose an end-to-end solution that delivers the scale you need from a partner you can trust.
If your organization is working with a third-party vendor for risk adjustment, quality data and analytics, ask yourself a couple very basic questions:
- Are our incentives aligned?
- Are we working towards the same goal, or do our interests conflict more than before?”
- Do I have the right partner, one I trust with of all of my risk and quality data?
When you do business in the Medicare Advantage, Medicaid and EDGE spaces, you cannot afford to give away anything to the competition. That means partnering with an ally who share your values, and whose interests are aligned with yours and your members’.
But beyond trust and reliability, you need an industry leader in technology and service at scale. One who provides an end-to-end platform including risk adjustment and quality analytics, submissions, EDI clearinghouse, member and provider engagement, value-based care solutions and clinical data exchange.
Close Clinical and Financial Gaps Via Secure, Agnostic, Bi-directional Interoperability
- Improve financial management via timely insight into premium and quality risk
- Remove barriers to accessing effective care with a large and diverse provider network
- Access an effective, easy-to-work with partner helping deliver higher quality care
- Empower patients to drive engagement, treatment compliance, higher satisfaction, and longer continuity of care
Proven Performance You Can Trust, at Scale
Beyond our commitment to open networks and common interoperability standards, Veradigm helps health plans to:
- Identify actionable interventions with patented Risk Adjustment Methodology with dynamic intervention planning empowers Payers to
- Access bi-directional clinical and financial data exchange between payers and 275k+ providers drives value for all stakeholders
- Streamline submissions and reconciliation via a comprehensive, cloud-based, fully integrated submissions platform for all government sponsored programs, including Medicare, Medicaid, CHIP, ACA and APCD (All Payer Claims Database).
- Monitor your key financial indicators and close gaps with a single, patented risk adjustment analytics and reporting solution supporting Medicare Advantage, ACA, Medicaid and Commercial analytics. Results can be tracked at both the population and the member-level detail, with recapture efforts for chronic conditions, identification of undocumented suspecting conditions. Patented Dynamic Intervention Planning provides health plans and payers an unbiased approach to precisely and efficiently targeting members for various intervention strategies including In Home Assessments and Medical Record Review.
- Automate and accelerate chart retrieval from providers and stop manually collecting and processing medical records with a proven solution that delivers access to 200k+ providers with multiple electronic health records (EHRs) for chart retrieval services. Our data parsing capabilities not only enhance our client’s Risk Adjustment suspecting analytics, but also provide clinical insights in support of gap closure – creating efficiencies and reducing costs.
- Track utilization and costs associated with the delivery of your value-based contracts with a common set of metrics for payers and providers to assess performance, increase collaboration, and decrease provider burden.
For more information on selecting the right vendor for risk adjustment and quality analytics and reporting, as well as encounter submissions, click here to check out a free purchasing guide with 8 Questions Every Health Plan Should Ask a Healthcare Analytics & Technology Partner.