Innovative tools to support retrospective risk adjustment chart review and regulatory audits

Health plans today are challenged with optimizing risk adjustment processes amidst escalating costs and increasing regulatory audits. The importance of accurate, efficient coding and data management practices cannot be overstated, especially considering the restarting of CMS RADV audits as well as the recent intensification of audits by the Office of Inspector General (OIG).

The Health Language Coder Workbench not only responds to these challenges but sets a new standard for excellence in the field. Leveraging the power of the Health Language Data Platform, the Coder Workbench combines clinically trained AI technology and semantically enriched medical terminology libraries.. We incorporate risk adjustment coding intelligence to ensure diagnoses that are coded are in alignment with the official guidelines for compliant coding and reporting, empowering health plans to navigate the complexities of risk adjustment with confidence and precision.

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Key benefits of the Coder Workbench for health plans

Speak to an expert to learn more about the Health Language Coder Workbench 

Delivering value to your Medicare Advantage Organization

25-30%

Increased efficiency over manual chart review.

5-7%

Net new codes identified and accepted by the client.

10-15x

Approximate ROI generated for a pilot evaluation of 100 charts.

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Transforming current risk adjustment processes

Gone are the days of manually reviewing each patient’s records and inputting data into cumbersome spreadsheets. The Health Language Coder Workbench organizes the chart, identifying present HCCs and linking them directly to supporting evidence within the medical record, and offers real-time visibility into coding progress and team projects.

A revolution in preparing for risk adjustment regulatory audits

At the heart of our latest innovation is the Regulatory Audit Module, a cutting-edge tool designed to streamline the workflow of any regulatory risk adjustment audit (i.e RADV, IPM, OIG). This module ensures the very best encounters are submitted for validation, significantly reducing extrapolation payment penalties and safeguarding your organization against noncompliance publicity. The module can also be utilized for internal audits, mock audits, and vendor audits.

Learn more about the Health Language Coder Workbench

Learn how the Health Language risk adjustment solution can support your risk adjustment processes. Complete the form below and we'll be in contact with you soon.

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