Elevating Accuracy. Strengthening Compliance. Maximizing Revenue.
Ascend Revenue Integrity delivers industry-leading risk adjustment, audit readiness, and revenue optimization solutions powered by clinical expertise and advanced analytics.
Who We Are
Ascend Revenue Integrity (DBA of Ascend Risk Adjustment Solutions, LLC) is a healthcare solutions company dedicated to risk adjustment, revenue integrity, and compliance optimization. Our mission is to deliver accurate, compliant, and defensible revenue outcomes while improving the depth and accuracy of patient care insights for our partners through human precision and advanced analytics.
Direct Strategic Partnerships
Medicare Advantage (MA) Plans
Accountable Care (ACOs)
Leading Provider Groups
ACA Marketplace Plans
Management Services (MSOs)
Overcoming Critical Challenges in Revenue & Compliance
Escalating Compliance Risk
The landscape of healthcare compliance is shifting rapidly. With the expansion of RADV audits across all Medicare Advantage plans and stricter CMS V28 models, organizations face unprecedented scrutiny. We solve the exposure to extrapolated penalties by ensuring every entry is defensible and audit-ready.
Uncaptured Revenue
Millions of dollars in CMS payments go unreconciled every year due to missed HCC coding opportunities and enrollment inaccuracies. We bridge this gap by identifying lost revenue through meticulous chart reviews and premium reconciliation processes.
Operational Complexity
Fragmented workflows and a lack of specialized clinical coding expertise often hinder audit preparation. Our operational solutions integrate certified professionals with advanced analytics to streamline inefficient processes and deliver scalable results.
10:1 ROI THROUGH RECOVERED REVENUE • REDUCED AUDIT EXPOSURE • DEFENSIBLE CLINICAL OUTCOMES •
Clinical Coding & Chart Reviews
Deep clinical validation through prospective and retrospective reviews. We identify missed diagnoses and ensure every HCC code is supported by defensible documentation to secure your revenue stream.
Audit Defense & Compliance Readiness
Comprehensive preparation for RADV and HHS-IVA audits. Our framework is built directly on CMS regulations, providing high-risk provider audits and workflow optimization that minimizes financial exposure.
Revenue Optimization & Reconciliation
Precision enrollment and premium reconciliation. We manage complex COB corrections and ESRD recovery through advanced analytics, ensuring billions tied to coding accuracy translate into realized revenue.
Why Leaders
Choose Ascend
Clinical Expertise First
Led by Registered Nurses and certified risk adjustment coders ensuring medical precision in every outcome.
Proven Compliance Framework
Built for RADV and CMS regulations, providing audit-ready and defensible documentation for health plans.
Technology-Enabled Accuracy
AI-assisted workflows paired with human validation to ensure high-precision insights and reporting.
Boutique, High-Touch Service
We offer tailored engagements and strategic partnerships focused on delivering measurable ROI for our clients.
The Ascend Engine
A proprietary platform integrating clinical expertise with advanced analytics to deliver defensible revenue outcomes and compliant risk adjustment solutions.
Human + AI = Precision
Unlike fully automated vendors, Ascend Revenue Integrity ensures clinical nuance is never missed by integrating human validation into every data point.
- Reviewed by certified coders
- Validated by medical graduates
- Optimized for v28 compliance models
- Designed for RADV and HHS-IVA readiness
Market
Ascend operates across high-impact healthcare programs where precision determines financial outcomes. With billions of dollars at stake , our accuracy ensures compliance and maximizes revenue integrity nationwide.
33.9M
Medicare Advantage Lives
Proven Results
$105
PMPM
Medicare Advantage Average Annual Premium Increase
24M+
ACA Members
$24
PMPM
ACA Individual Average
Annual Premium Increase
13M+
ACO Beneficiaries
98%
Accuracy
Proven Year-over Year
Expert-Led Healthcare Solutions
We combine clinical expertise with advanced analytics to deliver accurate, compliant, and defensible revenue outcomes for high-impact healthcare programs.
Risk Adjustment Solutions
Audit & Compliance
- Prospective Reviews: Capture current-year conditions effectively.
- Retrospective Reviews: Identify missed diagnoses and recover revenue.
- Chart Retrieval: Expertise in chart selection/collection for efficient and complete review
- Supplemental Data Generation: Deliver submission-ready files
- RADV Audit Readiness: Strategic preparation for CMS federal audits.
- HHS-IVA Preparation: Comprehensive validation for ACA marketplace plans.
- High-Risk Audits: Targeted review of complex claims to reduce penalties.
- Certified HCC Validation: Audit-ready precision driven by clinical experts.
Revenue Integrity
Consulting & Education
- Enrollment Reconciliation: COB and ESRD premium corrections.
- Payment Correction: Recovering unreconciled dollars from CMS files.
- Regulatory Optimization: Closing revenue gaps via advanced analytics.
- Enrollment Reconciliation: Aligning enrollment, premium, and code submissions for improved acceptance rate
- Provider Training: Documentation education to improve capture accuracy.
- Workflow Optimization: In-depth analysis to eliminate operational friction.
- Regulatory Advisory: Strategic guidance on model changes and compliance.
- Consulting Services: Trusted knowledge exchange and best practices to optmize in-house departmental efficiencies
Let’s Elevate Your Revenue Integrity
Visit Us
ascendrevenueintegrity.com
Location