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5 Essential Features in an HCC Risk Adjustment Software Platform

Posted By ECLAT Health Solutions

Whether you’re a Payer, Risk-Bearing Provider or Health System, the success and sustainability of your Risk Adjustment initiatives depend upon accurate HCC Risk Adjustment Coding capture and quality of documentation. Rigid accuracy standards are essential to achieving these goals in government Risk-Adjusted lines of business from Medicare Advantage to Managed Medicaid and ACA.

Providers and Risk Adjustment Professionals nationwide are seeking out technology-enabled risk adjustment solutions to complement and refine their ongoing efforts.

Finding the right solution can be daunting. While functionality, scope and transparency are naturally top-of-mind, it may be difficult to compare and contrast different options to determine which features combine the best user experience and the most impactful value in an HCC Risk Adjustment Coding technology.

To help streamline the process of choosing the best risk adjustment platform to onboard, search for these top 5 must-have features that your solution should include.

1. Does your platform feature a Concurrent Point-of-Care HCC Coding Tool and Retrospective Risk Adjustment workflows?

The most defining feature of an HCC Risk Adjustment Software Platform is the dynamic timeframes that it can be configured to according to your specific use case needs. Is your platform interactive and timely enough to manage Concurrent Coding at the Point-of-Care? Can it also look backward into Retrospective Reporting Periods or Calendar Years?

Each functionality is a vital component to your success and to attaining the proper HCC Risk Score. However, it is rare to find a single solution that has the ability for both concurrent and retrospective coding reviews. This dual focus is a significant indicator that you’ve found a high-quality, high-impact platform.

2. Is your current platform supported and validated by a professional HCC Risk Adjustment Coding Team?

While AI-assisted HCC Coding tools and rigorous analytical capabilities are powerful features with strong advantages, they cannot separate risk adjustment coding from judgment calls or decisions best entrusted to credentialed Coding resources.

This added safeguard allows for compliance audits and authentication at your team’s pace, scale and need with the added benefit of leveraging the certified team who is most familiar with the platform’s UI and HCC Risk Adjustment Coding capabilities.

3. Does your HCC Risk Adjustment Software offer comprehensive reporting and dashboards tailored to your role?

A Risk Adjustment Platform’s value isn’t just defined by its ability to complement the coders and auditors in the RA team. An essential feature is having impactful reporting capabilities and at-a-glance, customizable dashboards at your fingertips. A platform with this functionality and transparency is a powerful managerial tool. After all, the goal is to empower management to correct issues and identify trends with the speed required to adapt to them.

4. Can your HCC Risk Adjustment Coding Platform identify missed opportunities and specificity irregularities?

SaaS-based HCC Coding tools can also augment human coding capabilities with interactive access to its vast library of concurrent coding information. This provides coders with real-time assistance to help them to learn from missed opportunities and specificity irregularities.

Further, utilizing an active NLP/AI Risk Adjustment solution that compliments the coding process allows you to ensure complete documentation is captured efficiently to achieve world-class patient care.

5. Will your platform enable your HCC Risk Adjustment Coding efforts with timely coder-to-provider query communication?

Advanced risk adjustment coding technology can do more than assist in the coding process. A truly impactful solution helps your HCC Risk Adjustment Coding team improve performance and accuracy. Enabling communication between the coding and provider teams with a concurrent point-of-care solution drives more accurate results and faster turnaround for queries and corrections. This intercommunication is an important, potent capability in a comprehensive risk adjustment platform‘s suite and a crucial step towards provider documentation improvement and complete code capture.

The ECLAT Approach

The ECLAT Health Solutions approach to HCC Risk Adjustment Coding and chart review is about empowering opportunities to drive whatever success looks like for you and your team. Pair our expert team of certified HCC Risk Adjustment Coding resources with ECLAT’s SaaS Platform or utilize our customizable technology with internal teams. This all-encompassing approach provides a suite of solutions to deliver the technology and/or services you need at scale.

Partners can leverage ECLAT’s comprehensive, easy-to-use, web-based platform to elevate Concurrent Point-of-Care Coding efforts and expand your Retrospective Risk Adjustment capabilities. To explore the solution that meets and exceeds your needs at scale and to begin creating transformative, data-driven change, click below.

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Tags: HCC, HCC coding, Risk Adjustment, HCC Risk Score, HCC Risk Adjustment Software