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Revenue
IntegrityChange the way you identify risk, manage revenue,
maintain compliance and enhance performance.
More Information
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Revenue Integrity
Services for Medicare and Medicaid plans.
We believe the foundation for building a successful and integrated risk adjustment program is based on a solid understanding of the data so we can help clients with all elements of a fully optimized and compliant program. Our inclusive approach provides integration and management of all critical risk adjustment activities.
Revenue Integrity Solutions
Audit & RADV Support
Explore our solutions that include audits of outside or other previously used coding services.
Data Validation
A full review of all member encounter data and CMS risk adjustment submissions to identify each variance.
Medical Record Retrieval & Review
Capture additional revenue while maintaining strict compliance with the help of our certified clinician coders.
Premium Reconciliation
Ensure health plans are paid appropriately for every enrolled member with our financial reconciliation system.
Prospective Health Assessments
Identify and close gaps in quality and care while reducing expenses and improving risk score accuracy.
RAPS & Encounter Data Submission
RAPS files are prepared using our proprietary logic and our EDS solution maintains proper revenue recognition.
Reporting & Analytics
View detailed daily, weekly and monthly reporting on all aspects of our risk adjustment programs.
Revenue Integrity Technology
ReconEdge™, ChartNavigator™, EDSQ, and StarsNavigator - the industry’s most robust set of tools.
STARS Solution
Implement recommendations, track outcomes and improve your Star ratings through detailed insight.