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Wolters Kluwer Risk Adjustment Solution (VM)

door Health Language, Inc.

Risk Adjustment and RADV Audit Tool

Survive RADV audits with confidence. The Health Language Coder Workbench provides a project management tool that maximizes validation rates and minimizes penalties. Our cloud-based platform combines clinically trained NLP with CMS-aligned coding logic to help health plans efficiently navigate compressed 12-week timelines while coding up to 2,000 charts per contract. Smart chart organization and auto-populated ICD-10 suggestions accelerate workflows, while real-time dashboards provide operational visibility and a measurable impact across your entire Risk Adjustment program. • 25–30% efficiency gains over manual chart review • 5–7% net new, validated codes identified and accepted • 10–15x ROI observed in pilot evaluations of 100 charts • The Coder Workbench optimizes accuracy, speeds production, and elevates coder satisfaction. Transform your Risk Adjustment Operations with the benefit of a complete RADV Audit Response solution • Accelerate Chart Reviews: Smart table of contents and intelligently annotated charts reduce clicks and streamline coder workflows. • Maximize Code Accuracy: Built-in coding assistant delivers precise ICD-10 and HCC recommendations using clinically enriched terminology. • Ensure Regulatory Compliance: Integrated CMS rules and coding guidelines guarantee compliant documentation for every code recommendation. • Unlock Hidden Value: Identify diagnoses from unstructured data that traditional claims analysis misses. • Drive Operational Excellence: Real-time dashboards track coder performance, throughput, and project progress to optimize staffing decisions. • Excel in RADV Audits: Purpose-built project management capabilities that automatically prioritize high-confidence encounters, select optimal charts for maximum validation rates, and generate auditor-ready reports with full traceability.

Een overzicht

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