HARRISBURG, Pa., April 23, 2018 /PRNewswire/ -- Every year, health plans needlessly lose millions of dollars and face regulatory sanctions due to inaccurate HCC coding practices. A new whitepaper from Geneia, a healthcare analytic solutions and services company that is simplifying the evolution to value-based care, explains how health plans can use proven, automated technology to boost risk scores and revenue while simultaneously minimizing the burden on network physicians.
"Who doesn't love a win-win," said Geneia CEO Mark A. Caron, CHCIO, FACHE. "By using automated coding and machine-learning algorithms, health plans can increase their risk scores and revenue, and just as importantly, reduce the administrative burden on the physicians in their network."
In the white paper, health plans learn how proven technology helps improve health plan reimbursement and risk adjustment through:
Automated coding support – to detect and automatically populate missing HCCs year after year
Machine-learning algorithms – to continuously improve coding accuracy and optimization across unique and differentiated network contracts; and, to prioritize members based on risk-adjustment improvement potential
Clinical integration – to ease physician burden and reveal potential coding gaps within the EHR