Risk Adjustment Solution

Luminate

Lumanent is an expansive set of products and services with a focused approach and ambitious goal: Harnessing the power of the most mature, clinically-raised NLP on the market to distill medical data and claims information for payers and providers. Through that technology, our partners can improve their understanding of risk across lines of business and patient populations, empowering our partners to act on an illuminated, unprecedented view into their operation.

Whether it’s an EHR-integrated provider workflow, a retrospective review for payers, or diligent, effective advisory services, Lumanent lights the way for clients. When evaluating risk profiles of patient populations, implementing strategies to improve care plans, or maximizing revenue capture, the solution is Lumanent.

Enablers

Lumanent Connect lowers the cost of chart retrieval. It allows clients to automate the retrieval and management of medical records while also centralizing the storage of data for easy access and reuse.

With technology, newer is better. Except with artificial intelligence. AIs refine and grow with experience and well-curated volume of content “fed” into it. Lumanent Insights is the most advanced healthcare NLP engine in the industry. It has the longest standing clinical NLP technology, the earliest clinical NLP patents, and 350 million clinical documents processed: 139+ million of which through Health Fidelity client use alone. Lumanent Insights has processed 2.7 billion pages of clinical records and supports more than 9.6 million lives while providing a greater-than 95% accuracy rate in capturing the correct risk category.

Lumanent Suspects leverages NLP technology to identify prospective risk adjustment opportunities that are neither documented nor billed to governing entities from unstructured data in clinical charts. Suspects also scores each suggestion sifted out of the vast volumes of data based on confidence, guiding expert professionals to go forward more sure of their decisions.

Applications

Designed for use by broader care teams, our pre-encounter workflow gives staff NLP-derived intelligence from past medical history and facilitates the review of anticipated care gaps to validate areas that may require physician attention.

Point-of-Care is the only application directly designed for physician use. It delivers verified gaps to the physician at the point of care through the EHR during the visit, facilitating the workflow to capture accurate and complete documentation.

After the encounter, coders and billers receive NLP-powered verification of encounter documentation for all codes on claims, automatically checking for both additional coding opportunity and documentation audit compliance.

With Retrospective Review, cutting-edge technology combines natural language processing (NLP) and big data analytics to enhance retrospective and prospective data analyses with an intuitive workflow. This allows organizations to achieve better compliance, realize greater efficiencies, and maximize value through improved identification of HCCs.