They saw incremental results of 1:7 additional HCC per member, $229 incremental revenue PMPY, and 4X coder productivity. Because of the impact COVID-19 has had on encounter volumes, there may be no more important time to institute a priority-based recapture program. Through our NLP-powered solutions and expert advisory services, we uncover insights that enable better care plans and more complete revenue capture. Through a traditional HCC recapture at an annual wellness visit, current complications that are not acute may not be readily apparent, especially if the patient record does not reflect relevant diagnoses by a specialist in the prior year. Health Fidelity Overview Our risk adjustment solution automates CMS HCC coding operations, optimizes revenue capture, and ensures compliance for MA, ACA, MC, and ACO entities. In that circumstance, an NLP powered review of the patient would reveal an endoscopy and a prescription for Nadolol, both of which reveal portal hypertension and varices as a result of cirrhosis. The average employee at Health Fidelity makes $70,339 per year. Through our NLP-powered solutions and expert advisory services, we uncover insights that enable better care plans and more complete revenue capture. The pattern repeats throughout healthcare: diabetic supplies but no documented HCC for diabetes; oxygen delivery but no emphysema. 06-0646668). The benefit of prioritizing your HCC recapture rate comes directly from the requirement of re-confirming a diagnosis and treating it. HCC's Simulation Suite supports healthcare programs through the use of clinical simulation. Fidelity Select Medical Technology and Device Portfolio (FSMEX) Fidelity Select Pharmaceuticals Portfolio (FPHAX) Research Health Care at Fidelity. At the same time, if the DME claim is there the patient has a need for the chair. This is why a recapture program is absolutely necessary but, at the same time, only a first step. NLP, on the other hand, can take that (and other) DME claims into account, as well as pharmacy, labs, and prior diagnoses from previous years, and submit an appropriate code, as well as clinical evidence, for coder approval. we discussed the imperative of HCC recapture, insulating against audits through a vigilant internal compliance protocol, CMS Policy Update on Encounter Data and Positive Risk Score Impact, Medicaid Risk Adjustment: Even if Your State’s Medicaid Hasn’t Expanded, Your Risk Adjustment Strategy Should, Machine Learning in Healthcare and the Value of Human Expertise, Pre-Encounter Risk Adjustment: If You Try Sometimes, You Get What You Need, CMS Submission Deadline Extension Clarification, HCC Recapture is Critical, HCC Recapture is Never Enough. Save my name, email, and website in this browser for the next time I comment. However, HCC recapture is only a small part of the larger goal: discerning a complete and accurate risk profile of a covered population. It doesn’t capture conditions of new members of a population at all. To fully grasp the breadth and depth of conditions within a population, it requires experts in their fields to double and triple up their expertise, with doctors often learning basic coder practices, and coders making up any gap with thorough research through clinical notes. The confidence of knowing that the unstructured clinical data that had been captured over the years is now going to work to ensure that the greatest possible capture rate is achieved should bring comfort to that concern. This, in turn, stabilizes risk adjustment revenue year over year, ensuring care is provided to meet the patients’ clinical needs. To participate in the conference call, please call 1-844-340-9047 or 1-412-858-5206 10 minutes prior to the start time and reference the Warrior Met Coal (HCC) conference call. Lower patient volumes have led to the furlough and closing of primary care and specialist facilities across the country, further limiting the opportunity to treat patients and/or recapture chronic conditions. Health Fidelity simplifies risk adjustment, offering risk-bearing organizations clear visibility into and control over the process. Health plans tracking and prioritizing their recapture rate and opportunities closely were able to intervene earlier with their most critical members as CMS updates to telehealth launched, facilitating the quick spin up of new care delivery infrastructure to reach patients remotely, helping in the recapture of conditions through telemedicine visits. November 2020: Treatment of Diabetes – 2020 Updates; Cigna Announces New Strategic Alliance; The Equity Summary Score is an accuracy-weighted sentiment derived from the ratings of independent research providers on Fidelity.com. Health Fidelity's NLP engine identifies ICD and HCC codes, enabling clients to realize a 20-30 percent increase in risk capture. One State Street, Suite 19, Hartford, CT 06103 • Contact Us Donations to Hartford HealthCare are managed by the Hartford Hospital Department of Philanthropy, a Connecticut tax-exempt organization under section 501(c)(3) of the IRS code (E.I.N. Per semester and diagnosis modifications ) over time healthcare programs through the use of clinical simulation Read.... Learn in our new, state-of-the-art Center for Health Education is a high-fidelity simulation labs has! With 50 percent RAPS data all aspects of Health throughout the life cycle comorbidities... 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