Altegra Health Medical Record Review services enable our partners to confidently outsource the management of the entire hybrid chart review project, including chart retrieval and the completion of HEDIS®* medical record reviews. Coupled together with deep domain knowledge and expertise within HEDIS, as well as an efficient field reviewer and clinical reader workforce, our robust offering is built upon unmatched quality assurance, transparency, and customer satisfaction.
Clients can access and manage projects via our Web-based Alert Client Portal, which supports our proprietary chart retrieval and abstraction methodologies designed to minimize provider abrasion, while allowing health plans to continuously monitor the process. A vital feature includes RateMax™, which continually recalculates measures during the abstraction process to recalibrate the project as goals are met or priorities are shifted.
Altegra Health offers both on-shore, U.S.-based abstraction resources as well as off-shore resources, to allow greater flexibility in cost containment.
- Medical Record Collection and Tracking Systems – Gain full access to electronic chart requests, record-receipt documentation, scheduling and assignment, in and outbound faxing and electronic image parsing.
- Unmatched Transparency – Monitor and participate in the retrieval and abstraction project using our Web-based interactive client portal. At Altegra Health, your organization sees the same data we see, at the same time wee see it.
- Quality Assurance – Conduct thorough quality checks at multiple points throughout the process Clinical reviewers must maintain 95 percent accuracy based on staff-specific sampling. Project-level QA sampling occurs to assure 95 percent accuracy at the client level.
- Deep Domain Knowledge – Access Altegra Health industry experience – which includes the completion of hundreds of HEDIS compliance/validation audits with a 100 percent pass rate.
- Skilled Resources – Consider our team is comprised of trained field reviewers who fulfill on-site chart retrieval nationwide. Call center operations are centralized in multiple locations and operate multiple shifts to accommodate all time zones.
- Eco-Scaling™ – During HEDIS retrieval season, integrate coding and abstraction chase lists. Identify overlapping targeted member/provider combinations, retrieving the chart documents at one time, further minimizing provider abrasion and decreasing overall retrieval costs.
*HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).