Risk Adjustment Programs & Program Management

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Risk Adjustment Programs & Program Management

Risk Adjustment Program Management that Delivers

Advantasure’s comprehensive risk adjustment program can help you achieve accurate, complete and compliant risk score accuracy.

Strong risk adjustment drives success for health plans, but developing a comprehensive program is a challenge.

Combining strategic vision, innovative platforms, and industry expertise, Advantasure delivers a comprehensive, end-to-end risk adjustment solutions – and point solutions for specific challenges – tailored to meet the unique needs of your plan.

Without a strategic approach, and special attention to data submissions, provider engagement, member engagement and regulations associated with Centers for Medicare & Medicaid Services (CMS) plans miss opportunities to improve risk score accuracy, care and outcomes.

Advantasure manages over $7 billion in risk-adjustment-related revenue for clients.

Risk Adjustment Solutions

Prospective         Retrospective      Suspect Analytics        Medical Record Retrieval           Medical Record            Coding       Submissions Management         Risk Mitigation


Risk adjustment solutions

Our solutions utilize AI Machine learning and natural language processing (NLP) to improve risk score accuracy through medical coding, medical record review, gap identification and targeted member chase lists, and suspecting and reporting analytics.


You might like:

Podcast: RADV Final Rule
Podcast: Strategies for Reducing Gap and Chase Timeframes
Podcast: Predicting Member Conditions
Webinar: Strategies for Gap & Chase: Predict Member Conditions, Improve Outreach, & Reduce Gap Closure Timelines
Webinar: Best Practice Approaches for Balancing Business Needs with Regulatory and Compliance Standards

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