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The Opportunity and Benefits of the Clinical Review Specialist
A hallmark (and problem) of technology in healthcare has been the drive to automate processes and eliminate staff headcount to boost ROI. For risk adjustment operations in particular, this often results in an increased burden on physicians, asking them to learn and apply CPT, ICD-10, HCC, and any number of other codes alongside their primary […]
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ACO Benchmark Calculation: Successfully Understanding the two Levers of Cost and Risk
Our latest ebook, Pulling Both Levers: A Four-Year Analysis of Medicare Cost and Risk Adjustment, unpacks the critical, and often overlooked, importance of effective risk adjustment done in conjunction with medical expense reduction under value-based care.
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Flattening the Other Curve: Using Risk Adjustment to Manage Rebounding Patient Volumes
As care patterns continue to shift, and we see new utilization patterns, the stability of capitation and the revenue insulation provided by thorough, effective risk adjustment are key to thriving during uncertain times.
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Identifying Risk Adjustable Telehealth Patients in a Post COVID-19 World
Health Fidelity looked for a way to harness our expertise to assist our payer and provider partners provide continuity of care to their chronically ill patients. We decided to help providers identify and prioritize those patients who would be best served by telemedicine via a simple and quick suspecting report.
