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 advanced risk adjustment analytics strategy and deep subject matter expertise make it easy to assess program performance, identify and act on areas of opportunity, and measure the impact of your efforts over time.
Using our intelligent, cloud-based retrieval platform and NLP technology, we work with you to create centralized solutions for finding information across disparate sources — backed by over 13 years of experience.
We provide comprehensive risk adjustment coding services, delivering superior results that improve year-over-year. With diligence, attention to detail and deep technical knowledge, our team of experts helps you navigate the coding process with ease.
Our team brings years of expertise and a people-first approach to everything from data error management to risk score-informed prioritization.
Risk Adjustment Program Assessment
Leverage our advanced risk adjustment analytics strategy and deep subject matter expertise to assess your risk program performance. We will help you identify areas of opportunity, work with you to implement recommended interventions, and measure the impact of your efforts over time.
We use health plans’ historical claims and supplemental data to identify claims and conditions that are at high risk of regulatory audit.
Retrospective Compliance Cleanup
Our one-time consultative engagement service surfaces and resolves compliance risk in the months before final submission deadlines.
Medical Record Retrieval
We streamline the retrieval process for health plans and their provider networks through a repeatable, scalable, and customizable approach.
We offer four 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
Episource Final Check is an efficient, cost-effective final review of medical records that ensures full code capture and compliance prior to submission.
We help providers analyze historical member data to quickly and accurately categorize and identify patients who may need health interventions.
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.
We offer customized, data-driven provider education services that are made for clinicians, by clinicians.
Submitter Data Management
Our service ensures that your program is compliant with evolving CMS guidelines by executing complete reporting of your members’ medical events, enabling error corrections prioritized by risk impact, and providing a line of sight into potential risk scores.
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.