Our Retrospective Gap Identification platform leverages your existing data to identify gaps in member’s risk scores, enabling you to better direct your efforts.
Impacting risk adjustment with gap identification is critical. Retrospective programs require advanced machine learning capabilities to
target the right member at the right time and inform complete picture of gaps in process on performance in ways that avoid major issue for your business. This analysis provides critical insight and allows providers to close gaps during member health care visits and assure proper documentation of conditions on a claim and in the medical record.
Advantasure’s suspecting and gap identification is a technology solution that identifies missing or suspect codes to update risk adjustment documentation. Retrospective gap identification focuses on risk score and reimbursement accuracy based on review of previous year data and the creation of a medical record chase list.
Reducing the burden of effective risk adjustment management is an ongoing challenge – and sometimes overlooked by plans. Our experienced team has a deep understanding of health plan needs and the potential for gaps. We know the benefits you can achieve from a strong technology platform that delivers complete management of retrospective gap identification.
