Risk Adjustment
Solutions

We establish the client's preferred output formats to facilitate data exchange

Episource Risk Adjustment Coding Guidelines, which are updated yearly, are discussed in detail with each new client to clearly identify the standards by which medical records will be coded. These guidelines are based upon CMS/HHS publications and guidance, AHA Coding Clinic, and our experience in risk adjustment coding. We are flexible and accommodate specific requests.

• All data is analyzed to identify issues and errors and prior to processing
• We run data through our internal database and normalize it to obtain the most accurate and complete contact information
• We prioritize and group data to maximize medical record retrieval rates and minimize provider abrasion

As a product of our retrieval analytics, we determine the best chart recovery option that can include a full-service office visit, as well as a variety of self-service mail, fax, and EMR remote options.

Our fully-employed team of 1,700 coders (onshore/offshore) can scale quickly and complete coding projects of any size with the maximum level of accuracy and following a rigorous quality assurance process.

• View key project statistics including medical records retrieved, scheduled to be retrieved, being scheduled & Provider Not Participating 'PNP'
• Access coding results, and coding issues/mistakes by provider with Provider Scorecard
• Once records have been retrieved, view images via "ChartFinder”
• Ready-to-view reporting at the provider and member level, as well as customization options

• Track RAF progress at the member and provider level
• Discover additional opportunities for recapture
• Stratify members and launch HCC capture campaigns

• RAPS/ EDPS reconciliation
• Financial analytics
• Error prioritization and resolution
• Submission