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    Avoid errors by proactively engaging and educating physicians

  • img

    Prevent reoccurrence of gaps

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    Improve risk score accuracy and health outcomes

    Download Brochure
  • img

    Avoid errors by proactively engaging and educating physicians

    img
  • img

    Prevent reoccurrence of gaps

    img
  • img

    Improve risk score accuracy and health outcomes

    Download Brochure img
Challenges

< 35 %

Overall suspect validation rates

~ 30 %

Limited gap closure rates

< 25 %

Reduced ROI compared with benchmarks

Indegene Risk Adjustment Solution

Proactively driving improved risk adjustment outcomes

Indegene Healthcare's risk adjustment solution prevents reoccurrence of gaps and delivers improved health and revenue outcomes. The innovative approach uses tools, capabilities, and services that cut across Analytics, Technology, and Operations and is built on years of Medical expertise.

With proactive risk planning, documentation, and provider engagement, driven by industry-leading technology capabilities, we help improve risk score accuracy and risk-adjusted revenues for Medicare, Medicaid, and Commercial markets.

Solution Approach

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Develop a 360° view of the patient through EMR integration

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Proactively identify gap by looking for prospective member targets and setup encounters early in the year and avoiding retrospective gaps from occurring

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Reduce documentation errors by driving physician education and clinical reviews, ensuring risk score accuracy

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Improve coding accuracy using insights from NLP capabilities

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Achieve significant reliability in suspect analytics by leveraging on our extensive clinical knowledge while incorporating machine learning with the highest confidence levels

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Engage members effectively through omnichannel, provider-driven outreach to ensure higher receptiveness

Benefits
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Reduced risk of RADV audits

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Increased gap closure rates

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Improved ROI

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Better data for population health management

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Integration of risk adjustment with quality to decrease operational costs

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Decreased retrospective RA efforts over time