Accurate, Complete and Compliant Risk Adjustment Revenue Capture and Reporting
ATTAC’s risk adjustment experts help health plans, provider organizations and vendors implement effective risk adjustment programs for Medicare Advantage, Commercial ACA, Medicaid and ACOs.
Risk adjustment impacts the bottom line, and ensuring complete and accurate diagnosis capture and reporting of illness burden is critical. ATTAC’s experts can help you implement an effective and compliant program. Email our risk adjustment experts
Successful Medicare and ACA risk adjustment programs require more than hiring vendors for in-home assessments, analytics and retrospective chart review. Our team provides a range of consulting, advisory and auditing services, including:
HHS-RADV Initial Validation Auditing (IVA) ATTAC is one of the nation’s most trusted ACA HHS RADV auditors.
Risk Adjustment Program Optimization and Strategy. Selecting the right targets and mix of prospective, concurrent and retrospective efforts has a huge impact on your ROI. Using vendors effectively and applying controls to monitor accuracy and completeness of data are critical for revenue capture, compliance and to avoid false claims risk in Medicare Advantage and ACA risk adjustment.
Risk Adjustment Data Leakage. As data moves from clearing houses to claims systems, combines with delegate data, moves into data warehouses and on to EDS and Edge Servers, critical diagnosis can be lost and never submitted. Stop the leakage. ATTAC’s Data Trace and Data Leakage Assessments can improve ROI by 5 to 20%.
Risk Adjustment Program Design and Optimization for Providers.
Take revenue cycle management to the next level and develop the techniques, infrastructure, analytics, CDI and education tools needed to manage practice revenue.
Risk Adjustment Compliance and Over Payments. OIG continues to target accuracy and overpayments. Courts have upheld that plans must return overpayments to the government within 60 days to avoid False Claims liabilities. ATTAC can guide your organization through the complex process of complying with the requirements for identifying and returning overpayments. We provide the industry-proven models, processes and know-how needed to ensure compliance.
Other Risk Adjustment Program Advisory and Design Services
- Implementing effective prospective in-home programs and compliance oversight
- Retrospective chart coding over-read audits to test coding
- Risk adjustment vendor use evaluation and oversight
- Risk adjustment compliance controls, analytics design and risk mitigation
- Medicare RADV audit support
- Investigation support