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Our advanced risk adjustment analytics and suspecting solution identifies areas of opportunity, assesses program performance, and measures impacts over time.
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“We provide outcomes and metrics that basically show you the health of a health plan.”
Vijaya Vishwanathan, Episource Director of Product
Episource Analyst is a comprehensive, risk adjustment analytics workflow platform that turns data into actionable insights at the touch of a button.
Rich Analysis at Your
Fingertips
- Complete visibility for earlier intervention
- Program assessment driving actions
- Ranked chase lists
- Campaigns for measurable impact
- Innovations for all audiences, including Medicare Advantage, Medicaid, and ACA health plans
Recover Lost Opportunities
“After conducting an incremental codes-to-claim analysis, Episource found a lost revenue opportunity of ~$428 per member per month.”
– Health Catalyst
Unparalleled Results
Episource Analyst helped one regionally managed care organization achieve a 30% RAF increase within just two years of implementation.
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.
Data-Driven Insights
Our experts deliver a comprehensive analysis that highlights how your risk adjustment program has performed historically and where there are opportunities to increase impact.
Set Program Strategy
We provide strategies and recommendations that impact the most critical elements of patient care and program performance enabling you to make real-time decisions that drive outcomes.
Seamlessly Execute Interventions
Our people and platform significantly reduce the administrative burden required to manage and analyze data, implement strategic programs, and continuously measure success.
Compliance Review
Generated by Episource Analyst, this comprehensive report identifies claims and conditions that are at high risk of regulatory audit.
Audit Prevention
Avoid an audit from CMS or OIG by identifying the practices that commonly trigger audits and flagging HCCs at high risk of an audit.
Complete Transparency
Compliance Review provides visibility and transparency into the specific HCC codes that flag an audit. We provide a segmented breakdown of members across four key categories of risk.
Seamless Integration
Our Compliance Review service is seamlessly integrated within Episource Analyst — a one-stop shop for compliance needs. Utilize both to close gaps, solve for RAF score, and be RADV- and CMS-compliant.
Deep Analysis
Expert Analytics
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