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Risk Adjustment

Coronavirus Updates

As the pandemic continues to affect risk adjustment programs, Episource helps you keep track of the government’s policy response. Updated regularly.

Risk Adjustment

DIY or Vendor: Should You Partner for Risk Adjustment Services?

With the recent changes to the existing risk adjustment model and the higher percentage of encounter data that will make up risk scores, health plans are now focused more than ever before on ensuring they’re prepared to secure the same RAF. To assist in your preparations, our Vice President of Client Services gives you the insight on the top priorities you should consider before making important vendor decisions.

Risk Adjustment

ONC & CMS Final Rulings Grant Patients Unprecedented Control of Health Data

On March 9, senior healthcare officials announced the release of two of the most extensive rulings ever passed around the way electronic health information is exchanged: the CMS Interoperability and Patient Access Final Rule and the ONC Cures Act Final Rule. The separate but interrelated rulings represent a huge step forward for interoperability and increased patient access, giving members unprecedented control over their health data.

Risk Adjustment

COVID-19 Coding Operations Update

As COVID-19 has shut down the in-person operations of businesses across the globe, the pressure is on for risk adjustment vendors to remain stable and shift their coding operations to a work-from-home setting. While many vendors are not set up in such a way to easily make this transition, Episource has been able to quickly and seamlessly migrate our global teams to work from home with no impact to quality or deliverables.

Risk Adjustment

CMS Releases Telehealth Ruling Regarding Applicability of Services for Risk Adjustment

In response to the incredible burden placed on American healthcare institutions by the novel coronavirus outbreak, the Centers for Medicare & Medicaid Services have announced their decision to allow diagnoses captured during telehealth visits to be risk adjustable.

Risk Adjustment

COVID-19 Brings Telehealth to the Forefront

In a bid to contain the novel coronavirus (COVID-19), President Trump declared a national emergency on March 13, unlocking $50 billion in aid and expanding Medicare telehealth benefits. Aimed at providing Medicare beneficiaries greater access to healthcare services, the move will help members receive safe, continual care while limiting exposure and spread of the virus.

Risk Adjustment

ONC, CMS Interoperability Rules: A Review

Recently, the Office of the National Coordinator for Health Information Technology (ONC) released a draft of their Strategic IT Health Proposal for 2020-2025. This proposal addresses the deliverables included in the 21st Century Cures Act, which focuses on making health data accessible to patients and care providers, increasing choice, encouraging competition, and fostering innovation.


Episource Securely Connects with Austin Go Language Community

Episource can help major health plans achieve 95% accuracy for medical record coding and retrieval, but that’s only possible because 100% of Episource is made up of great people passionate about making healthcare better. Since the Go Language community has been instrumental to helping us build solid, secure, and performant software, we jumped at the chance to speak with them in Austin.


Generate Gap Letters in 90 Seconds with epiAnalyst

Building a product from scratch gives the freedom to identify necessary changes and build them out quickly. Our product team takes this to heart during regular updates to our in-house analytics platform, epiAnalyst, as they develop its feature set.

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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