Cotiviti Completes Acquisition of Edifecs.
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Effectively identify members with suspected but potentially undocumented conditions
Starting your risk adjustment program with a strong analytics foundation is key to improving efficiency and results. However, identifying the right priorities can be a challenge. Cotiviti's Suspect Analytics solution helps identify members with potentially undocumented conditions, as well as risk and probability of success, to optimize your efforts. Our advanced analytical models provide our clients with a nuanced examination of their data, predicting which members have the highest probability of missing or incomplete conditions. Our solution enables plans to:
Improve risk adjustment results while minimizing provider abrasion
Health plans need to acquire, exchange, and share large volumes of clinical data to support appropriate reimbursement and drive quality member care. A successful retrieval solution operates efficiently at scale and allows health plans to conduct outreach in a coordinated, minimally intrusive manner using a range of options from EMR integration to traditional mail and fax.
Cotiviti's Medical Record Retrieval solution offers comprehensive, web-based medical record retrieval, aggregation, indexing, and storage. It features strong digital data exchange capabilities and interoperability strategies, which combine with Cotiviti's expertise in leveraging traditional channels such as fax, email, and phone to help address gaps or barriers and optimize results. Medical Record Retrieval allows plans to:
Accurately capture and document risk-adjustable conditions
Medical record coding is complex, with guidelines and requirements that are constantly changing and evolving. Health plans need a partner to reduce complexity and manage coding compliantly, efficiently, and effectively at scale.
Cotiviti’s Medical Record Coding solution enables health plans to accurately capture their population risk while delivering high quality results. Leverage natural language processing (NLP) technologies, integrating them with our teams' expert leadership, an in-depth understanding of the healthcare industry, and our proven best practices to:
We also offer Second Level Review for charts previously coded, enabling health plans to add a layer of protection and optimize results by integrating our coding and quality assurance expertise.
