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The Episource Clarity Platform

The Episource Clarity Platform is an end-to-end platform for risk adjustment and quality initiatives. It delivers tangible outcomes for our nation’s leading health plans and risk-bearing providers by supporting all aspects of risk adjustment across the enterprise, including analytics, program management, gap closure, reporting, and CMS submissions — all while delivering superior client services, flexibility, and the ability to deliver at scale.
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Our risk adjustment analytics platform turns data into actionable insights at the touch of a button for Medicare Advantage, Medicaid, and ACA health plans, as well as provider groups.
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Using our intelligent, cloud-based retrieval platform and NLP technology, Episource Hub gives provider groups timely electronic access to clinical data across disparate sources.
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Episource Coder offers NLP-powered coding tools to empower payers and providers to code charts and audit in-house vendor work with more accuracy and efficiency.
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Episource Encoder is a real-time production coding encoder tool designed to maximize the speed in which coders find the code they are looking for and complete their coding projects.
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Episource Submitter offers an integrated encounter data error management and submissions solution to streamline error corrections and prioritize based on risk score impact.
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Risk Adjustment
Program Assessment

Leverage our risk adjustment analytics expertise to assess program performance. We’ll help you identify areas of opportunity, implement interventions, and measure the impact of your efforts over time.
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Compliance
Review

Generated by Episource Analyst, this comprehensive report identifies claims and conditions that are at high risk of regulatory audit. These results are segmented across four key categories of risk.
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Medical Record
Retrieval

With more than 14 years of experience, we’ve streamlined the medical record retrieval process for health plans and their provider networks through a repeatable, scalable, and customizable approach.

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Concurrent
Review

Leverage our best-in-class NLP technology and our deep bench of experienced coders to efficiently identify confirmed and suspected diagnoses to document on your claims.
Code

Retrospective
Review

Uncover unsubstantiated codes and improve clinical documentation accuracy with our comprehensive retrospective coding services, executed by the industry’s largest full-time coding team and our proprietary NLP engine.
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Chart
Audits

We offer multiple levels of chart audit services that adapt to your workflow and provide unparalleled results. Choose the chart audit service based on your specific needs.
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Final Check
Review

Final Check Review is an efficient, cost-effective second-level review of medical records that ensures over 95% coding accuracy and full compliance prior to submission.
Code

Pre-Visit
Review

We analytically distill the year-over-year diagnoses and clinically-suspected diagnoses that clinicians can address — all in advance of a patient visit.
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MAC Portal Submissions for Retrospective Coding

Our retrospective coding service offers ACOs an efficient, reliable method to correct submitted codes without expending hours of labor.
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Encounter
Data Management

We ensure that your program is compliant with evolving CMS guidelines through reporting of your members’ medical events and enabling error corrections prioritized by risk impact.
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Financial
Projections

Produce up-to-date financial reports based on your encounter data and its current status. You can also view revenue projections for each encounter data error to help you prioritize by financial impact.
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Clarity at Every Stage

Industry-leading software solutions

Expert teams behind every product

Real-time visibility

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