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Integrating Risk Adjustment Tools Into Clinical Practice

Risk adjustment tools in clinical practise
Episource
November 20, 2024

Integrating your risk adjustment tools into your practice is a key component for a functional and profitable business. Doing so raises opportunities to address specific gaps in clinical workflows, gain insight into your patient populations, and shift toward value-based care.

How Integrating Risk Adjustment Tools Can Help Improve Your Practice

Data is powerful – but accurate, well-documented data is unstoppable. By implementing and incorporating risk adjustment tools into your operations, you can generate reports and analyses around what areas of care your team focuses heavily on, and what areas may be missed.

Additionally, some risk adjustment tools can help identify areas of care that some patients could benefit from but still need to receive. By leveraging these reports and building processes around them, you can identify these gaps and take any necessary action.

As mentioned before, accurate, well-documented data is the best way to optimize your practice and remain compliant. With risk adjustment tools placed in the right parts of your business, you can audit and evaluate gaps you may have in your data collection or in your overall documentation.

Episource Analyst provides a wide range of customizable reports and analytics that can highlight the gaps mentioned above and much more.

The Growing Role of Technology in Risk Adjustment

Much like other industries and jobs to be done, the role of technology in clinical risk adjustment has grown significantly, driven by the need for improved accuracy, efficiency, and scalability in managing patient populations.

Coding Tools

Technology has also empowered practices to become proactive and even predictive with their patient data, rather than just producing a receipt of patient care. Take, for example, Episource’s Pre-Visit Review, which begins the coding and insights process before a patient steps through your doors. This not only reduces the amount of documentation that must be done during and after the visit, but it also gives your team the ability to prepare and anticipate patient needs during the visit.

Of course, not all necessary details are captured during this intake process. Technology has developed to provide user-friendly tools that do not interrupt the flow of the visit taking place. This allows the healthcare provider and staff to provide more attentive care while documenting necessary details. Episource Coder has coded over 40 million charts since 2008 and continues to grow its support for practices across the US.

Chart Auditing

Even with some of the best tools and technology available to us, user error feels inevitable. To help with this, risk adjustment tools – such as Episource Coder, help provider groups review the results of coding and ensure accuracy.

Episource enhances coding quality for provider groups through specialized chart audit services

1. Basic Chart Audit: Our expert team conducts thorough reviews to identify coding discrepancies.  

2. NLP-Enhanced Chart Audit: This combines manual review with Natural Language Processing to minimize human error.

3. Final Check Review: We leverage NLP to detect inaccuracies and overcoding from previous vendors, ensuring compliance with industry guidelines.

These services help provider groups improve coding accuracy which helps enhance patient care. 

Integrating Episource’s Risk Adjustment Tools Into Your Practice

For clinical practices, effective risk adjustment tools are essential to your operations. At Episource, we offer a comprehensive suite of integrated solutions designed to support key aspects of medical coding, compliance, and risk adjustment.

To learn more about how our tools and services can benefit your organization, reach out to us today.

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