Value-based programs take a variety of forms, but they all have one thing in common: their success depends on effective and efficient risk adjustment. Health plans need to maximize revenues, identify risk-adjustable opportunities, and minimize coding errors, all while remaining compliant with changing regulatory guidelines.
With the Edifecs Risk Adjustment Coding Suite, your organization can achieve each of these objectives—and you can do it at scale with a single, unified solution. Our AI-powered, cloud-native suite is designed to cover all areas of your risk adjustment operations, from retrospective and pre-submission coding to compliance, submissions, and even audit support.
Ensuring complete and accurate payments is the key to succeeding in value-based care.
Edifecs’ Risk Adjustment Coding Suite helps make a big job more manageable.
Ready to Thrive in Value-Based Care?
End multi-vendor management headaches and unify your risk adjustment operations with Edifecs.
Leverage our NLP engine to combine claims information with unstructured medical data and establish a single source of truth about your covered population’s disease burden.
Say goodbye to multi-vendor headaches using AI-enabled coding automation with integrated encounter submission and analytics tools.
Work smarter, not harder. Our best-in-class NLP and machine learning (ML)-derived insights help you find more risk-adjustable opportunities, faster.
Stay on top of changing CMS guidelines with 2nd-level reviews and AI-powered redaction logic that helps protect against future audits.
An integrated approach to your entire risk adjustment operation helps ensure your organization remains compliant, scalable, and able to adapt to any changes.
