We use only experienced certified medical coders, with over 1,500 coders worldwide. Episource provides these services to many of the largest healthcare organizations in the U.S.
As HCC thought leaders, we provide flawless execution and outstanding client service, placing a major focus on coding guideline reviews and industry updates. We accurately report patient risk profiles based on the capture of risk-adjusting ICD-10 codes, ensuring payers are appropriately reimbursed for treating their members.
Superior coding accuracy driven by better people, training, technology, and processes
Unmatched transparency and access to reporting
Data validation to mitigate audit risk
Client customizations (guidelines, coding output formats, comment codes, reporting)
Greater member and provider level insights
Confidence – no shortcuts in compliance, training, or management
SELECT TARGET CHARTS
Identify and prioritize specific provider offices and charts
CHART RETRIEVAL PROCESS
Utilize all forms of retrieval methods (remote EMR, email, SFTP, fax/mail, onsite/copy service)
HCC REVIEW AND CODING
Review HCC values and coding results
REPORT CODING RESULTS
Robust reports detailing coding results provided
We provide retrospective coding services for Medicare, Commercial/HIX, and Medicaid Lines of Business using specific models: CMS-HCC, HHS-HCC, and State Specific Medicaid Models.
This review identifies key diagnoses that are:
- Received on claims and can be validated by medical record documentation
- Not received on claims supported by the medical record
- From claims that the medical record does not properly support (and the underlying cause of that lack of support)
- On the medical record but lack proper support, indicating opportunity for future analysis and/or provider education
Episource provides all of these findings through our online portal, epiConnect.