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Claims Assistant performs a gap analysis on claims files to suggest HCC codes which may have been billed by other providers or by the patient’s primary care provider in the previous calendar year. Submission of all appropriate codes gives the plans and Medicare a more accurate view of the patient’s condition and anticipated healthcare expenditures.
Medical groups can upload claims files into Claims Assistant for on-demand analysis. Claims Assistant instantly analyzes dates of service, diagnosis codes, and billing providers to identify missed HCC coding opportunities. Results of the analysis are easy to understand, and can be viewed online, filtered, and downloaded in spreadsheet format. Based on analysis of dates of service, diagnosis codes and billing providers, a gap analysis is performed within seconds and the output is displayed in an easy to read format. The output can be filtered in multiple ways and maybe be printed or exported to a spreadsheet.
360-degree View and Rich Insights
For solo practitioners on up to MSOs and ACOs, claims data from payors provides a complete picture of the patient’s interactions with the health care system. Analysis of claims data can therefore provide rich insights into those interactions leading to improved reimbursement and reduced costs of care.
EHR Integration – New for 2020!
Results of the Claims Assistant’s gap analysis can be pulled into athenaClinicals and other leading EHRs. This gives the provider the opportunity to record missed HCC codes within the EHR workflow, saving significant time researching and documenting.
Fast Go Live!
Our set up process is fast and easy. Organizations small and large can go live and start taking advantage of the application within days of signing an agreement.