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.
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.
Using our intelligent, cloud-based retrieval platform and NLP technology, Episource Hub gives provider groups timely electronic access to clinical data across disparate sources.
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.
Episource Submitter offers an integrated encounter data error management and submissions solution to streamline error corrections and prioritize based on risk score impact.
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.
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.
Retrospective Compliance Cleanup
With this service, our compliance and analytics experts ingest your organizations data and surface 10+ categories of high-risk codes and audits these for ICD-10 compliance.
Medical Record Retrieval
With more than 14 years of experience, we've streamline the medical record retrieval process for health plans and their provider networks through a repeatable, scalable, and customizable approach.
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.
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.
Pre-Visit Review
We help providers analyze historical member data to categorize and identify patients who may need health interventions, minimizing the number of retrospective audits that need to be performed.
Concurrent Review
Our concurrent coding services leverage our best-in-class NLP technology to quickly and efficiently review codes, flag errors, and translate hard-to-read provider notes.
Provider Engagement
We offer customized, data-driven provider education series that are made for clinicians, by clinicians. These ranges from 1:1 training with individual providers to population-level group activities.
Submitter 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.
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.