Maximizing Revenue and Reducing Risks with Veradigm Risk Mitigator for RADV Audit

KB at your finger tips

This is one stop global knowledge base where you can learn about all the products, solutions and support features.

Products-Allscripts

Maximizing Revenue and Reducing Risks with Veradigm Risk Mitigator for RADV Audit

Understanding the Financial Consequences of a RADV Audit

Undergoing a Risk Adjustment Data Validation (RADV) audit from entities like the Centers for Medicare and Medicaid Services (CMS) or the Department of Health and Human Services (HHS) can pose significant financial risks for health plans and payers. Unsupported Hierarchical Condition Categories (HCCs) found in such audits may be extrapolated to represent an error rate affecting the overall population, impacting organizations profoundly. Even a single unsupported condition in a RADV audit sample can lead to substantial financial implications.

Introducing Veradigm Risk Mitigator

Veradigm's Risk Mitigator, formerly known as Valid8, aims to identify and address risks related to data validation audits effectively. By analyzing claims and submissions data, Risk Mitigator ensures adjustments are made accurately, considering the specific HCCs and risk adjustment models of programs like the Affordable Care Act (ACA) and Medicare Advantage (MA). This tool serves as a crucial component in mitigating the financial impact of RADV audits, safeguarding organizations against revenue loss.

Key Features of Risk Mitigator

Risk Mitigator offers a range of key features to support health plans and payers. It identifies high-risk conditions and providers, providing actionable insights for research, correction, and educational purposes. By distinguishing between 'False Positives' and 'False Negatives,' Risk Mitigator ensures accurate risk assessment. Moreover, it supports both HHS RADV and Medicare RADV audits, offering comprehensive risk mitigation solutions tailored to specific program requirements.

Enhancing Risk Mitigation with Data Insights

Veradigm leverages data mining and extensive experience in data validation exercises to enhance Risk Mitigator's capabilities. By pinpointing conditions prone to coding errors and vulnerable to audits, this tool assists in identifying providers and groups with documentation deficiencies. By combining Risk Adjustment Analytics with Risk Mitigator, organizations can optimize revenue generation while effectively managing audit risks, ensuring compliance and financial stability.

Partnering with Veradigm for RADV Risk Mitigation

Veradigm's Risk Mitigator serves as a proactive risk management solution for health plans and payers, aiming to minimize the impact of Data Validation Audits on organizations. By providing a comprehensive approach to analyzing and addressing potential risks, Risk Mitigator acts as a safeguard against revenue loss and compliance challenges. Partner with Veradigm to leverage the power of Risk Mitigator and secure your organization's financial well-being.

Stay Ahead in Today’s Competitive Market!
Unlock your company’s full potential with a Virtual Delivery Center (VDC). Gain specialized expertise, drive seamless operations, and scale effortlessly for long-term success.

Book A Meeting To Setup A VDC

Streamline Patient Care with Practice Fusion EHR Software

Efficiency in Patient Care

Practice Fusion EHR offers a cloud-based solution that allows healthcare providers to access information securely and effectively. The platform is designed to streamline workflows, making charting more efficient and simplifying the management of patient care plans. With features like certified e-prescribing, imaging and lab integrations, and automatic updates to meet best practices and regulatory compliance, providers can save time and focus more on patient care.

Read article

Optimizing Healthcare Management with Veradigm Payer Analytics

The Importance of Effective Risk Adjustment in Healthcare

Effective risk adjustment in healthcare plays a vital role in ensuring accurate funding allocation and optimizing patient care. Veradigm Payer Analytics offers a comprehensive suite of solutions that cater to the needs of Health Plans and At-Risk Providers, helping them navigate the complexities of the healthcare landscape with ease. By addressing various functional areas such as Finance, Actuary, and Pharmacy Program Management, Veradigm ensures that every aspect of the healthcare strategy is covered, leading to improved outcomes for all stakeholders involved.

Read article

Veradigm Real-World Evidence: Unleashing the Power of Data-Driven Insights

Understanding Real-World Evidence

Real-world evidence (RWE) is crucial in today's healthcare landscape as it offers a deeper understanding of how therapies perform in real-life scenarios, beyond traditional randomized controlled trials (RCTs). RWE is derived from real-world data, encompassing clinical evidence on the benefits, risks, and usage of medical therapies. By utilizing various research methods like observational studies, RWE provides a comprehensive view of treatment effectiveness across different patient groups.

Read article

Revolutionizing Healthcare with Veradigm Connect

Innovative Healthcare Solutions

Veradigm Connect serves as a bridge between cutting-edge health technology solutions and the healthcare professionals and patients who can benefit from them. By eliminating the typical barriers associated with implementing new technology, Veradigm Connect empowers innovators to make a tangible difference in the healthcare ecosystem. Through a free developer portal account, users can access a vibrant community of like-minded individuals dedicated to transforming healthcare and driving value and insights.

Read article

Enhancing Clinical and Financial Workflows with Allscripts Veradigm Healthcare Provider Solutions

Streamlined Practice Management

Allscripts Veradigm offers a comprehensive suite of healthcare provider solutions to help practices streamline their clinical and financial workflows efficiently. These solutions are designed to reduce the administrative burden associated with regulatory and reimbursement requirements, improve practice financial performance, and enhance patient satisfaction. By leveraging Veradigm's Practice Management Software, practices can boost productivity by automating scheduling, collections, and claims management, thus making more informed business decisions through intuitive dashboards and real-time financial forecasting.

Read article

Welcome to Knowledge Base!

KB at your finger tips

Products-Allscripts