Advantmed offers integrated solutions to help healthcare organizations improve performance.
Claims data that’s up to CMS standards. And yours.
Get the validation and the reimbursement you deserve.
Incomplete, incorrect, or missing claims data can mean the difference between meeting CMS requirements or a potential impact on your reimbursements. Trust the accuracy and completion of your claims and data validation to our proven process and detail-oriented experts.
Our 4-step process
Our in-house Claims Validation team confirms that each claim’s documented HCCs are supported in the medical record. This reveals any incomplete, incorrect, or missing data before it’s submitted.
Taking the claims data you provide, we map all diagnostic codes to HCCs to ensure accurate risk adjustment scores.
We then review and blind code a chart, and match the clinical data back to the claims data for additional due diligence and accuracy.
We report any unsupported HCCs back to you as unconfirmed so you can take the appropriate action.