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Risk Adjustment

Risk Adjustment2024-05-08T12:12:12+00:00

Transforming Risk Adjustment with Health Chain

Health Chain empowers Payers to manage the health of their population with precision by identifying gaps in care, proactively implementing targeted interventions and ultimately reducing the care management burden for providers to optimize the cost of care.

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Omega Patient Access App

Health Chain Impact Stories

Single Source of Truth for RA Teams

Providing teams with the comprehensive and real-time data they need, consolidating member information into one data model.

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Scoring Precision that Drives Results
Scoring Precision that Drives Results

Ensure more accurate, real-time RAF profiles for every member – enabling Payers to optimize reimbursements for both themselves and their providers.

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Proactive Care Management

Gain deeper insights from Day 1 into each member’s clinical profile to implement targeted interventions, personalized care plans and preventive measures from the outset.

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Lightening the Load for Providers
Reduce Provider Abrasion

Eliminating chart chasing, recapture processes and administrative burdens for Providers with real-time data ingestion at scale, across sources.

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Omega Patient Access App

Data Integration Simplified

By ingesting PDF charts, Data directly from provider EMRs, Model Output Reports (MORs) from CMS, claims data, and member supplied information, Centaur Data Platform seamlessly integrates all data to create longitudinal member records. Say goodbye to data silos and scattered information – enable the creation of holistic views of each member’s health profile, empowering your team with comprehensive, real-time data.

Streamlined Data Extraction

RiskRevPro streamlines the ICD-10, HCC and Clinical Keyword extraction process using AI – providing risk adjustment teams with only the most relevant and critical data to calculate and assign risk scores. Risk Adjustment teams no longer need to spend hours reviewing dozens of pages of clinical profiles.
Coverage and Claims
Access Medical Records

Unlocking Usable Data

Access to usable data is vital for risk adjustment analytics. Epsilon HCFhir+ converts all data into a curated relational data model, enabling RA analytics at scale in a cost-effective manner. Our platform excels in HCC and ICD-10 extraction using AI, ensuring your team has the necessary insights to make efficient, data-driven decisions.

Immediate Access to Historical Clinical Data

Payer to Payer Hub facilitates immediate access to members’ historical clinical data and risk profiles, with member consent. For both new and existing members, Payers can have immediate access to the historical information they need to identify and assign accurate risk profiles to each member.
Coverage and Claims
Access Medical Records

Real-Time Insights from Data

We believe in democratizing access to data – enabling your team to effortlessly extract valuable insights. HC SQL AI enables business users to query risk adjustment related databases without requiring SQL knowledge – reducing time-to-insights and supporting real-time risk management.

Why Choose Health Chain?

Perspectives by Health Chain

Read insights from Our Risk Persona

Upcoming Webinars

Mark your calendars for our upcoming webinars – discussing how Payers are implementing digital platforms to better integrate data across business units. Choose an area of focus below:

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