Health Plans enjoy improved risk score accuracy and Star measures when their provider base participates in proactively closing care gaps and maintaining compliant record documentation. Traditionally, these activities increase the workload on providers who are already spread thin. That’s why the Advantasure solution seamlessly integrates with EMRs, using automation to guide providers into documentation workflows with actionable insights that are unique to each patient at the point of care.
Prior to the patient visit to their doctor, clinical documentation alerts (CDI that include risk adjustment HCC & quality HEDIS gaps) are given to providers in any way they can and prefer to accept them including directly into the providers existing EMR to ensure all member conditions are accurately and completely documented while closing quality gaps at the point of care. On a concurrent basis we check the provider’s work to assure the medical record and their claim supports the chronic condition or HCC code and work with the doctor to improve their documentation capabilities
Make it easy for your providers so together you can raise the standard of care and improve HEDIS measures, Star ratings, risk score accuracy, and reduce HRADV/RADV audit risk.
Monitor key metrics at the practice, provider organization, or health plan level for performance review, identification of long-term trends, and ad-hoc analysis.
Hit the ground running with fast, easy, one-time set up and provider training available both in-person or live streamed sessions.
Managing risk means partnering with your providers to enhance the quality of care for members and improve the quality of claims data. This provider-led program has consistently performed to improve documentation accuracy and reduce risk.
On average, customers experienced a 10-15% improvement in risk scores.
Star ratings improved an average of 5% due to identification of care gaps via auto-suggestions.
Care gaps were closed on more than 75% of addressable conditions via CDI alerts.*
*Based on aggregate user experience data for Advantasure’s PEC Program.
The on-site Provider Engagement Program is implemented via our team of physician reviewers and certified coders to review medical records and identify documentation opportunities and clinical alerts.
We offer opportunities for peer-to-peer collaboration and education so your providers are up to speed on medical record documentation requirements.
Together, you and your providers can close care gaps and reduce member risk scores.
