September 9, 2020
Episource at RISE West 2020
September 9-11, 2020
Episource was founded with a singular mission: To simplify healthcare.
That mission has become more critical than ever as health plans face unprecedented challenges to delivering care. Working with a vendor should make the Risk Adjustment process easier, not harder. Yet all too often that is not the case. That is why we have designed our comprehensive suite of Risk Adjustment solutions with all of the common vendor pain points in mind: Poor performance and lack of flexibility, tech that is not versatile enough, inability to leverage data analytics effectively or efficiently, and lack of transparency and accountability.
We are reinventing the way healthcare organizations manage their member populations. Schedule a 1:1 with a member of our team today to find out how.
How to connect with us during the conference:
Identifying and Correcting Data Leakage Prior to RAPS/EDS Claims Submission
Thursday, September 10th
4:10 – 4:55 PM EST
A case study on identifying and correcting data leakage prior to claims submission, presented by MediGold’s Amber Harris and Mike Sloan alongside Episource’s Director of Risk Adjustment Analytics, Meleah Bridgeford. The group will review how the two organizations successfully conducted audits on MediGold’s claims submissions and identified missed HCC opportunities. This presentation will cover the steps taken to initially recognize lost opportunities, clarify and quantify the missed submissions, and correct the process which led to improved submission accuracy and acceptance rates.
Director, Risk Adjustment Analytics
Meleah Bridgeford oversees Medicare, Medicaid, and ACA risk adjustment analytics and services at Episource, providing strategy and direction for risk programs of all sizes. She has over 10 years of experience within healthcare organizations as well as vendor/consultant organizations.
Director Risk Adjustment
Manager, Risk Adjustment Submissions and Analytics
With half of the year already come and gone, third quarter Risk Adjustment needs to account for shortcomings in performance and capitalize on successful campaigns. Before the second half of the year, health plans have an opportunity to improve clinical documentation omissions or errors, meet with patients in-person or virtually, and develop chart review campaigns to record codes and identify issues in charting that can be corrected before the end of the year.
Key topics covered:
- Expectations plans should have for RAPS/EDPS reconciliation
- Indications of data leakage that affect claims and encounter submissions
- Quantifying the value of lost opportunity in submission performance
- Effectively reconciling submissions in time for sweeps
Check out our additional resources, including white papers, on-demand webinars, toolkits, and more.
View our resources here
Meet with our Experts – Virtually
Senior members of our team will be available during the conference. Make an appointment to talk to them about: