Medical Record Retrieval & Clinical Review Solutions
A one-stop solution for medical records retrieval, coding, and abstraction for healthcare payers that want to increase incremental revenue and quality ratings.
Promote Accuracy, High Retrieval Rates, and Transparency
Easing the medical records retrieval and clinical review process for risk adjustment, HEDIS, and Stars
Risk Adjustment (RA) and HEDIS ratings are a priority for payers, as these scores impact a plan’s attractiveness, NCQA certification, bonus payments, and rebate payments. Submission of accurate patient data is required for RA processes, HEDIS criteria and CMS payments.
Gathering medical records with minimal physician abrasion can be challenging. Scaling your coding and abstracting operations can also prove difficult, as coding guidelines continue to evolve. Data gaps can cause payers to lose money if providers do not sufficiently document patient information or possible diagnosis codes on claims.
To meet supplemental data guidelines, payers need high medical record retrieval rates and the necessary clinical expertise to code accurately.
Experience, clinical expertise, and economies of scale
Change Healthcare has over 20 years of experience in medical records retrieval and clinical review. We have both on-shore and off-shore operations centers that use data enhancement and cleansing technology to achieve high patient chart retrieval rates with minimal provider abrasion.
Our large capacity allows us to accommodate all our clients’ needs, averaging 3 million charts per year. Our Medical Records Retrieval and Clinical Review teams only employ clinical experts to code and abstract charts that can result in 97% accuracy. Data can be delivered to any certified vendor for submission.
Our clients value our expert coders and rigorous quality processes, as well as the transparency we provide. With our secure Alert Portal, clients can view chart status and updates in real time.