Risk Adjustment Coding Suite

To succeed in value-based care, health plans need to take advantage of every opportunity to maximize revenues and ensure complete, accurate payments. That means spotting coding errors before claims are submitted and collaborating effectively with their provider partners to close diagnosis gaps. Unfortunately, that's often easier said than done.
Most health plans are struggling just to keep up with the sheer volume of clinical data coming their way. There’s barely enough time to process it all—and definitely not enough time to comb through the data and look for risk-adjustable opportunities.
Edifecs’ cloud-native, SaaS-based Risk Adjustment Coding Suite leverages AI & NLP technology to help coding teams spot and close diagnosis gaps, identify more suspected conditions, and cut down on coding errors. That means less time spent on administrative tasks—and more time working to achieve the plan’s operational, compliance, and financial goals.
How do we do it? Watch this video to find out.

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