Risk Adjustment

Episource Simplifies Risk Adjustment for Healthcare

LOS ANGELES, March 2, 2017 /PRNewswire/ — Episource, a leading healthcare business services and technology company for Risk Adjustment and Quality Improvement, today announced the launch of new product features for epiAnalytics, its Risk Adjustment Analytics and Workflow Platform, and epiEncounter, its Encounter Submissions, Error Management, and Financial Analytics application. The new features will be introduced during the RISE Conference 2017 taking place in Nashville on March 6.

Some of the new features include:

  • epiEncounter: With the new functionality, epiEncounter is now a one-stop tool for error management, RAPS-EDPS reconciliation, financial analytics and submissions. The new features include Error Management and Financial Analytics that enable healthcare organizations to identify errors and prioritize rejections by HCC, and identify discrepancies between RAPS and EDPS submissions with associated financial impact.
  • epiAnalytics: Users can now generate Risk Adjustment Campaigns (Prospective and Retrospective) based off population segmentation, a functionality that is unique within the risk adjustment ecosystem of analytics solutions. The ‘Campaigns’ feature helps organizations to identify which programs are contributing a higher ROI, and provides analytics that are easy to understand and share across the organization.

Both applications are part of Episource’s full suite of products, which also includes epiConnect, a client portal where users can monitor progress of all medical record retrieval and coding projects, and that is included for all clients with active projects.

Episource started its journey into the risk adjustment world more than 8 years ago, when Sishir Reddy, Episource’s co-founder and CEO, identified a need for quality medical record review services for healthcare payers. According to Reddy, “By leveraging a global workforce of certified medical coders operating in Episource’s provider revenue cycle management division, we saw tremendous opportunities to provide quality and cost effective HCC coding services to government health plan programs.”

“With strong partnerships built with our health plan customers and a recognition of the industry moving towards value-based care reimbursement models, we developed a vision to provide both products and services around risk adjustment and quality reporting with a focus on simplifying workflows in the system of payers, providers, and patients using intelligent and actionable data.”

But while the company is looking toward the future, Episource doesn’t forget its roots. Their medical record retrieval and coding services are still a key part of their core offering and continue to grow exponentially every year. Episource also offers a consultancy practice, developed naturally from the many Health Plans and other healthcare organizations the company has served throughout the years.

About Episource

Episource is driven to collect data that’s insightful and accurate. With innovative technology and a global services model, our mission is to help Payer and Provider Healthcare Organizations meet their members’ needs in a way that results in better patient experience and health outcomes.

From robust Risk Adjustment Analytics, Retrospective Chart Reviews, Quality Reporting, Encounter Data Submissions, and Clinical Services, Episource starts with the smallest details and translates them to create better insights around patient disease profiles and care gaps.

Episource is headquartered in Gardena, California with additional operations in India and the Philippines. For more information on Episource, visit www.episource.com

Press Contact

Claudia Gallardo


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

Presentation @ RISE VBC: Effective Collaboration Strategies Between Payer & Provider