Risk Adjustment Solution Edifecs

Risk Adjustment
Data Acquisition

Extracting clinical data and retrieving charts from EMR systems is a time-consuming and arduous endeavor. Too many health plans rely on manual workflows to complete the data acquisition process. Not only does this place additional strain on overburdened IT teams and EMR vendors, it also ties up valuable resources that could be better utilized elsewhere.

Edifecs EMR Link & Chart Hub use AI-powered process automation to seamlessly integrate with EMRs, extract the necessary data, and transmit it back into our Risk Adjustment solutions. That means less time focusing on tedious, time-consuming work—and more time focusing on the bigger picture.

Spend More Time Focusing on What Matters

Edifecs helps health plans reduce manual processes and improve coding accuracy.

Risk Adjustment Solution 1
  • Manage both manual retrieval and e-retrieval from a single platform
  • Automate chase lists, campaigns, and worklists
  • Auto-assign and rebalance workloads based on chart priority and deadlines

Automate your workflows

Reduce administrative bloat with more efficient data acquisition.

HCC Risk Adjustment 2
  • Reduce duplicative work by highlighting charts already in the system
  • Track campaign, chart, team, and vendor performance
  • Utilize on-demand reporting to quickly get everyone up to speed

Improve transparency for all stakeholders

Keep all departments aligned and informed with cross-department collaboration.

Risk Adjustment in Healthcare 3
  • Automate chart transmission and reconciliation with Edifecs RA solutions
  • Compare actual HCC findings with NLP predictions to ensure accuracy
  • Immediately re-fetch metadata, chart file data, and claim data as needed

Leverage an end-to-end solution

Manage the entire chart reconciliation process from a single unified solution.

News & Insights

Edifecs EMR Link
An NLP-powered, e-retrieval solution: Automated chart retrieval with scalable technology to reduce manual analysis, improve coding accuracy, and enhance member outcomes.
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Edifecs Chart Hub Data Sheet
Edifecs Chart Hub is an integral part of the Edifecs health plan solution approach, enabling the quick retrieval of high-value charts while reducing costs, increasing chase efficiency, avoiding duplicative chase efforts, and decreasing provider abrasion.
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Risk Adjustment Overview Data Sheet
A comprehensive risk adjustment strategy: Scalable solutions and services designed to ensure revenue integrity and CMS/State compliance for managed care plans.
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