Risk Adjustment Software Reviews and Ratings
What is Risk Adjustment Software?
Risk adjustment software is a specialized tool used primarily in healthcare to adjust payments and evaluate performance based on the health risk profiles of patients. It helps ensure that organizations are fairly compensated for the care of patients with varying health statuses and that comparisons of performance and quality across providers are equitable. Typical users include healthcare providers, who use it to accurately capture and document patient conditions, and health plans and payers, who analyze patient risk profiles to manage financial risk and predict future healthcare costs.
Product Listings
No filters available
The company is an AI chart review organization that combines advanced AI with expert knowledge from medical doctors, certified coders, and compliance professionals to improve operational efficiency in the healthcare sector. The firm's primary focus is to uncover concealed revenue options, implement automated audits for ensuring regulatory adherence, and provide valuable clinical conclusions that enhance patient care and end results. The AI-driven approach, fortified by the specialized knowledge of the team, increases accuracy and efficacy. By noticeably decreasing labor expenses, the solution enables resource reallocation towards significant projects and fosters an environment of constant enhancement and quality patient care.
Cotiviti operates in the realm of healthcare, using up-to-date technology and detailed data analytics to enable healthcare providers to deliver efficient care at reduced costs. The organization's strategies serve as a vital base for healthcare payers, assisting them in their objective to minimize healthcare expenses and enhance quality by improving payment accuracy, risk adjustment, consumer engagement, and network performance management programs. In addition, Cotiviti works within the retail sector, providing data management and recovery audit services to boost business performance.
EXL is a data analytics and digital operations and solutions company. It partners with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to generate insights from data and deliver outcomes for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others.
Recognizing that businesses have unique needs, cultures, goals, and existing technological set-ups, EXL emphasizes collaboration and flexibility in its approach. EXL also aids in the scaling of AI, Generative AI and digital usage, redesigning operating models for added efficiency, and facilitating quicker, more effective decision-making. EXL looks into the entire value chain of a business to integrate impactful strategies and deliver successful outcomes that align with the goals of the business.
Innovaccer Inc. focuses on providing a data platform for value-based care. Its primary function is to unify patient data across different systems and care settings. The platform further empowers healthcare organizations through scalable and modern applications which contribute to enhancing clinical, financial, operational, and experiential outcomes. The platform’s efficiency and agnosticism towards specific EHRs have led to its adoption across numerous hospitals and clinics. Additionally, it aids providers in the healthcare industry to collaborate efficaciously with payers and life science companies. It has assisted customers by unifying health records and generating cost savings. The platform has also been acknowledged for its proficiency in data and analytics, and population health technology.
Founded in 1998, Milliman MedInsight is a provider of healthcare data and analytics for payers, providers/ACOs, employers, and government agencies. Our comprehensive suite of analytics and data solutions empowers organizations to leverage healthcare data for informed decision-making and improved clinical and financial outcomes. With deep industry expertise and advanced technology, we deliver actionable insights into healthcare utilization, costs, quality, and performance. From risk management to value based care, Milliman MedInsight empowers stakeholders to navigate the complexities of the healthcare landscape and achieve sustainable success.
Founded in 1998, Milliman MedInsight is a provider of healthcare data and analytics for payers, providers/ACOs, employers, and government agencies. Our comprehensive suite of analytics and data solutions empowers organizations to leverage healthcare data for informed decision-making and improved clinical and financial outcomes. With deep industry expertise and advanced technology, we deliver actionable insights into healthcare utilization, costs, quality, and performance. From risk management to value based care, Milliman MedInsight empowers stakeholders to navigate the complexities of the healthcare landscape and achieve sustainable success.
Optum, a subsidiary of UnitedHealth Group, concentrates on improving healthcare system effectiveness and promoting healthier lives. Operating globally across 150 countries, its main function is to connect and engage all aspects of healthcare. Advanced technology, extensive healthcare data, and expertise are utilized by Optum to boost the quality, efficiency, and delivery of healthcare services. The broad array of services offered, including healthcare delivery, healthcare operations, pharmacy care services, population health management, and advisory services, are angled towards refining health plan simplicity and improving experiences to promote healthier lives. Integrity, compassion, relationship building, innovation, and performance are integral to the company's operations.
Persivia, previously known as DiagnosisOne, was established in 2005. The company is rooted in Massachusetts and was created by a group of physicians and healthcare IT professionals. The company primarily offers a unique integrated platform called CareSpace, that utilizes artificial intelligence to gather and analyze data from various databases and create a precise longitudinal record for every patient. This AI-driven platform has a feature called CareTrak that enables bi-directional connectivity with EHRs. Another unique feature, SmartPHIN, supports state public health departments in managing large-scale epidemics like COVID-19. Through this platform, Persivia aims to improve the management of value-based care models and provide real-time, personalized patient care insights. The firm serves 200+ hospitals and has a user base of more than 8000, impacting over 20 million patients nationally.