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.

High Retrieval Rates, Accuracy, and Compliance

Medical Record Retrieval

Scaled capacity

Retrieving a large quantity of high-quality data can be challenging. Our team of experts retrieves medical records in ways that are convenient for providers, using RSVP advance scheduling, fax and email campaigns, FTP, Dropbox™, EMR, and even client-requested special handling rules to retrieve the data you need.

Our call capacity is 30,000 calls per day. We collect charts from ~250,000 providers in all 50 states.

Coding & Abstraction Accuracy

Meeting risk adjustment and quality guidelines

We only hire individuals with clinical backgrounds for our coding teams. Our smart technology highlights key words on patient charts, helping to increase coding efficacy and efficiency. Our internal quality checks help to ensure our work is accurate and consistent.

97% Accuracy

Increased Compliance

Meet NCQA compliance and coding guidelines

We stay on top of annual submission and coding guidelines and provide comprehensive training to your employees. Superior training and data-driven management techniques allow us to more efficiently meet compliance requirements.

Explore Our Medical Record Retrieval & Clinical Review Solutions