Our Services:

• HCC Capture: Accurate coding of chronic conditions to optimize risk-adjusted payments.

• Quality Measure Support: Assistance with key measures, including:

  • Annual Wellness Visits (AWVs)

  • Physical exams

  • Colorectal cancer screening

  • Breast cancer screening

• Payer Coordination: We manage communication with payers to ensure compliance with quality standards.

Monthly Guidance: Ongoing support to track and achieve quality goals.

Benefits:

• Increase Revenue: Capture quality measure incentives, such as:

  • HEDIS Bonuses: Earn higher reimbursements for meeting metrics like preventive screenings and chronic disease management.

  • Star Rating Improvements: Boost CMS Star Ratings for increased shared savings in value-based care programs.

  • Payer Incentives: Secure additional payments from HMSA, MDX, Humana, and UnitedHealthcare for meeting quality targets.

• Save Time: Reduce administrative workload and focus on patient care.

• Payer Expertise: Navigate complex requirements for HMSA, MDX, Humana, and UnitedHealthcare.

How It Works

1. Initial Assessment: We identify gaps in your quality measures and HCC documentation.

2. Customized Plan: A tailored strategy to meet payer-specific goals and maximize incentives.

3. Continuous Support: Monthly audits and check-ins to ensure consistent performance.

4. Reimbursement Alignment: We align our services with your payer contracts, optimizing for monthly or yearly quality bonuses and risk-adjusted payments based on your specific agreements with payers like HMSA, MDX, Humana, and UnitedHealthcare.