CONSULTING SERVICES

ASSISTING CLIENTS ACROSS ALL MARKETS

Episource offers a full range of consulting services for risk adjustment organizations across all lines of business: Medicare Advantage, Commercial/HIX, and Medicaid.

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OVERVIEW

Our goal is to integrate our expertise in different aspects of healthcare operations, improving quality of care and increasing business process efficiencies. We have comprehensive experience in assessing and developing improvement projects.

BENEFITS

Enhance quality of care

Develop efficiencies

Increase awareness of risk adjustment opportunities

Improve risk adjustment programs

Risk Adjustment Program Design and Management

Episource has the expertise to assist with the design of your risk adjustment program, from the largest details to the smallest. With years of experience serving some of the most successful plans in the country, we can point the way toward improved reimbursement and patient care through a comprehensive Risk Adjustment strategy.

When assessing projects, we ask ourselves the following questions:

  1. What steps should an organization take to build a successful Risk Adjustment program?
  2. How does an organization’s risk program compare with best in class programs (people, knowledge, process, strategy, and technology)?
  3. Are there opportunities related to specific members? Providers?
  4. Is the organization using all the tools available in a strategic and cost effective way in terms of chart audit, member outreach, annual assessments, home visits, and provider attestations?

Regulatory Advice

Episource provides regulatory advice and education on a wide variety of coding and risk adjustment topics for management, providers, coders, and medical office staff. We keep abreast of new guidance and policies from DHHS and CMS, as well as relevant changes from the AHA Coding Clinic and other industry sources.

We provide:

  • Updates to the CMS-HCC, Rx-Hcc, and HHS-HCC models
  • Risk Adjustment concepts for providers, staff, coders, and administrators
  • Documentation and coding information and updates
  • Effects and transition tips for ICD-10

EXPLORE MORE

  • Healthcare Solutions

    Retrospective Chart Reviews

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  • Healthcare Solutions

    Provider Coding Educators

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  • Healthcare Solutions

    RADV Audit Support

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