Chart Retrieval & Risk Adjustment Coding
Efficiently document and report diagnoses with timely, accurate documentation
We offer a full-service coding solution for all risk adjustment coding: ACA-Commercial, Medicare Advantage, and Managed Medicaid. Our solutions – retrospective chart retrieval and review, risk adjustment data validation (RADV) – support the effort to capture missing risk adjusting diagnoses and ensure members are appropriately risk adjusted.
Since 1996, our chart retrieval and coding services have provided proprietary automated workflows, a national network of field reviewer for data collection, and the most experienced clinical auditors in the industry, combined to provide the most effective solutions for retrospective improvements in risk score accuracy.
Retrospective coding is an integral component to a sound risk adjustment strategy. Our proven service delivery model takes chart review to the highest level, ensuring timeless, quality, accurate documentation and optimal results.
- Suspect Targeting – Use direct client data from our proprietary RISK View™ risk analytics tool to project and achieve optimal revenue outcomes.
- Provider Scheduling – Gain efficiencies with chart retrieval scheduling using our proprietary process, which allows for the management of special handling requirements and identifying key sites as well as active engagement in resolving unretrievable chart.
- Chart Retrieval – Access proprietary technology and provider-sensitive processes to achieve high rates of provider participation and high provider satisfaction scores. Chart recovery methods offer provider flexibility and are HIPAA-compliant, tested, and secure, including onsite retrieval, fax, mail, EMR and EMR CCD data exchange.
- Clinical Review (Chart Coding) – Recognize the value of a compliance-based approach to medical record coding, delivered by American Health Information Management Association (AHIMA) or AAPC-certified coders who capture or delete risk adjusting diagnostic codes and perform data validation audits. Our partners receive cost flexibility by choosing from US-based or off-shore operations.
- Quality Review Processes – Assure the highest standards of coding quality, with quality checks occurring throughout the process.
- Alert 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 overreads, download chart images and generate reports.
- Data Validation – Confirm the accuracy of existing diagnosis data from health plan or provider documentation. Use customized data to facilitate multiple audits and reviews.
- ACA and MA RADV Support and Mock RADV – Customize the support services you need with our experienced staff who provide full audit support from start to finish.