Risk Adjustment Solution Edifecs

Risk Adjustment
Point of Care Suspects

Identifying clinical indicators and flagging risk-adjustable opportunities are essential to complete and accurate risk adjustment coding. Being aware of these opportunities is essential—but the ability to quickly act on them is even more important.

Our SaaS-based Point of Care Suspects solution leverages industry-leading natural language processing (NLP) to quickly scan and analyze historical patient data across all sources and formats and present suspected risk-adjustable conditions within the provider’s clinical workflow.

With Point of Care Suspects, provider organizations can improve productivity and reduce time-consuming manual processes for clinicians and staff. No more cumbersome workflows, spreadsheets, or flat files; just the right information, at the right time, in the right place.

The Right Information at the Right Time

Edifecs helps harness and deliver the clinical data providers need to care for their patients.

Risk Adjustment Solution 1
cleanse
  • Reduce time spent reviewing historical chart data
  • Focus on active conditions impacting patient care and treatment
  • NLP suspecting identifies up to 30% more risk-adjustable opportunities compared to manual methods

Get the information that matters

Minimize unnecessary manual reviews with automatic routing directly to the EHR.

HCC Risk Adjustment 2
focus
  • Enhance capture of both initially coded and recaptured conditions
  • Track and manage provider performance against KPIs
  • Create stronger connections between codes and clinical evidence to reduce compliance risk

Do more for patients

Deliver a more patient-centered experience

Risk Adjustment in Healthcare 3
act
  • Route substantiated clinical evidence directly to providers
  • Reduce charting time with pre-populated ICD-10 codes
  • Ensure accurate and complete care funding and reduce rejected claims

Put insights to good use

Focus on the conditions with the biggest impact on patient health.

News & Insights

Point of Care Suspects Data Sheet | Edifecs
Learn how productivity, compliance, and collaboration can be achieved simultaneously through integration and automation with Point of Care Suspects.
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Practical Understanding of NLP in Risk Adjustment Technology Webinar | Edifecs
In this webinar, our panel of experts discusses the technological trends that can ease the burden on clinicians and help them succeed in both alternative and traditional payment models.
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Risk Adjustment for Providers Guide
Complete and accurate risk capture is essential to success in value-based contract performance. This guide examines the four points of opportunity where provider organizations can identify and address gaps to achieve greater financial results, ensure regulatory compliance, and enhance care quality.
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