ELEVATE! Risk InsightsTM is Advantmed’s comprehensive risk adjustment solution for health plans, managed care organizations and other risk-bearing entities.
The revenue optimization process begins with ELEVATE! Risk Insights, our risk analytics engine, which calculates historic and potential risk scores and determines suspected morbidities leading to both revenue optimization and cost containment opportunities. Uniquely, the ELEVATE! Risk Insights solution builds off the information produced by our own ELEVATE! Risk Insights risk analytics or the output from other risk analytics tools.
Advantmed incorporates ELEVATE! Risk InsightsTM into our ELEVATE! Healthcare TM platform providing ongoing insights to understand the drivers of medical and financial risk and the ability to take action to ELEVATE! Risk Insights through the optimal combination of services such as medical record retrieval, medical record coding by certified coders, identification of documentation of service gaps and both member and provider engagement services that close those gaps.
Summary of ELEVATE! Risk InsightsTM, Advantmed's end-to-end risk adjustment solution
Fully-managed import of all key health plan data
Process data through all major risk models
Identify non-optimized members due to projected RAF scores or suspected morbidities
Specify chase logic for prioritization of medical record retrieval
Medical record retrieval services
Medical record coding services
Monitor progress of coding project and revenue optimization activities in real-time
Identify service gaps and documentation gaps from coding
Member and provider engagement services to close gaps