Revenue / Risk Management Services
Revenue and risk services focus on the three key challenges of increasing profitability, reducing complexity, and managing regulations.
Our revenue management solutions accelerate revenue recognition and realization. Our system centers around interoperability, which enhances the effectiveness of sales and account management.
Our risk management solutions mitigate risks while ensuring business continuity. We combine data analytics and visualization to help organizations better understand the business context and apply data to prevent failures, service disruptions, and revenue loss.
We offer Medicare Risk Adjustment (MRA) services through our internally managed systems. Our systems are continuously updated to properly estimate what dollars are required for each member and conduct regular audits to ensure proper coding.
We utilize complex algorithms to identify the most viable opportunities that yield the highest possible financial impact for the plan. Our logic focuses on the following areas: medical history of the member, RX data, Lab data, DME usage, and CSNP eligibility of the member.
MRA Services Offered:
- Field Data Collection and Analysis
- Chart Review
- CMS Reporting