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.