Simplifying healthcare

We are reinventing the way healthcare organizations manage their member populations with an integrated platform. Combining intelligent technology and expert teams, we empower the most recognizable names in healthcare with end-to-end risk adjustment solutions.

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EPISOURCE PRESENTING ON SEPT, 1 AT RISE WEST

Surfacing High Risk Diagnosis Codes: Leveraging OIG’s Methodology to Better Ensure Integrity in Submissions

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MISS OUR RISE WEBINAR ON JUNE 28?

Analytics & Accuracy: How to Improve Program Performance by Surfacing Complex Conditions

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FUTURE-PROOF YOUR 2022 RISK ADJUSTMENT PROGRAM

Discover how advanced technologies like AI and NLP can improve program performance.

EXPLORE INSIGHTS

MISS US AT RISE RISK ADJUSTMENT FORUM?

Learn the importance of implementing NLP to increase accuracy and surface complex diagnoses, particularly in the ACA market.

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RISE MEDICAID MANAGED CARE

Master the complexities of Medicaid risk adjustment with 3 analytics-driven strategies.

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SIMPLIFIED WORKFLOWS FOR HEALTHCARE PAYERS AND PROVIDER ORGANIZATIONS

RISK
ADJUSTMENT

Improving implementation, operations, and management of risk adjustment programs for Medicare, Commercial and Medicaid health plans and risk adjusting organizations. Explore risk adjustment solutions that drive accuracy and outcomes.

Learn about our Risk Adjustment Process

QUALITY ANALYTICS
& REPORTING

Advanced analytics, made with your members in mind. Measure performance, identify gaps and launch targeted campaigns to meet your data goals.

Discover how our quality solutions can help you

HEALTH RISK
ASSESSMENTS

We assess the health of your members in any setting, closing documentation gaps for risk adjustment and quality programs.

Read More About Our Clinical Services

Identify Hierarchical Condition category Coding (HCC) gaps, stratify members, and follow simple workflows to close gaps faster than ever before. Share reporting and insights within minutes or download reports at the member and provider level.

Act on new insights with epi analyst

Simplify your encounter submissions with detailed reports on the financial impact of your RAPS/EDS data, resolve errors, reconcile, and submit — without the complexity and in one single tool.

Track your financial results with epi encounter

epiCoder dashboard showing 4 pending L2 charts

Code charts in-house or audit vendor work. Integrating Artificial Intelligence in healthcare is key to providing a better service, so we created epiCoder to meet your risk adjustment software coding needs.

Code charts and audit vendor work in-house

SEE OUR LATEST POSTS

Jul 27, 2022

How Health Systems Can Build Resilience & Downside Risk Performance Through Value-Based Care Operations

Here are three key steps healthcare organizations can take to successfully transition to value-based care.

Jun 15, 2022

A Holistic Approach to Help Providers Transition to Value-Based Care

CMS is expecting 100% of providers to accept downside risk by 2025. Three key opportunities for organizations to assist providers in the transition to value-based care delivery.

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We simplify the management of member programs by making it radically more efficient, and increasing value to healthcare organizations and their members