Risk Tracker
What is Risk Tracker?
The Risk Tracker Solution from RecordsOne enables Revenue Cycle leaders to conduct pre-bill, post-bill and prospective HCC audits of patient claims. This solution will also help to quickly identify important diagnoses that may be missing, impacting Risk Adjustment and by prioritizing the claims for review based on the claim value.
Our nSight Analytics engine supports thousands of permutations of items that could be missing from the claim, and can include an automated review of the documentation in comparison to the claim. That’s right… Heart Failure Documented doesn’t mean it was coded and that the associated HCC was captured.
Our flexible and extensible framework allows for numerous configurable workflows that support your business processes… not the other way around. We configure for you.
Computer-Assisted Risk Adjustment
“My Pop Health team needs to know which claims are the most important to look at first…”
We can determine which claims based on your criteria — RAF score regression; missing specific HCCs; documentation that has HCC uncoded, etc — or various combinations… we have it!
Claims can be routed to various teams and team-members based upon the automated findings. We support simplistic and sophisticated workflows that work for you.
Users have the ability to retrospectively audit HCCs as well as prospectively identify, validate and communicate with CDI and Coding teammates — regardless of tools those teammates are using.
Sticky notes don’t work for software — but R1 NOTES do. Leave a note for yourself, or send one to the coder, or maybe your supervisor and have it live with the encounter. Keep it simple — simple is better.
NOTES can be both public and private, so you can share them with other teams, or just your team.
Focus
- Identify missed HCC opportunities
- Identify RAF slippage by value, percentage or both
- Identify HCCs that were documented and not coded (NLP)
- Prioritized findings with claim escalation rules
- Configurable to your needs
Features
- Financial impact reporting
- Trend reporting
- Secure communications within the tool
- Web-based for easy access and limited IT involvement
- Reference data at your finger tips