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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

Elevating accuracy and strengthening compliance through clinical expertise and advanced analytics.

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