Advantmed offers integrated solutions to help healthcare organizations improve performance.
Making sure your claims data meets CMS requirements.
Never miss a reimbursement opportunity.
Incomplete, incorrect, or missing claims data can lead to less than ideal reimbursements. Trust our claims and data validation to our proven process and detail-oriented experts
Our proven 4-step process
Step 1
Validate
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.
Step 2
Map
Taking the claims data you provide, we map all diagnostic codes to HCCs to ensure accurate risk adjustment scores.
Step 3
Review
We then review and blind code a chart, and match the clinical data back to the claims data for additional due diligence and accuracy.
Step 4
Report
We report any unsupported HCCs back to you as unconfirmed so you can take the appropriate action.