Manage the Quality & Effectiveness of Submission Data

Manage the Quality & Effectiveness of Submission Data

Tightly managed processes, integrated internal and external technologies and systems, and a tremendous amount of careful governance are required to effectively run the data preparation and quality assurance aspects of your risk adjustment program

Related:

  1. Organize & Integrate Member Data
  2. Develop Powerful, Flexible Insights
  3. Orchestrate & Improve Performance of Engagement Activities
  4. Manage the Quality & Effectiveness of Submission Data
  5. Optimize Program Performance

Manage the Quality & Effectiveness of Submission Data

Whether you are documenting the results of supplemental diagnoses activities, predicting future year opportunities or simply managing your membership and claims data for successful CMS acceptance, the same standards for rigor and quality apply.

How we can help

  • Source-to-target traceability – enable rock-solid traceability from projected scores and opportunities to originating claims and membership data for audit purposes and issue identification
  • Data quality assurance – build systems and processes to uncover and proactively address likely data quality and rejection issues before they become problematic
  • Submission data management – automate processes for outbound file preparation and inbound file ingestion