Quality & Coding Management
Monitor real-time care delivery, quality, and coding gaps to alert stakeholders and optimize quality of care and financial performance.
Our Quality & Coding Management solution provides case managers with visibility into member care needs and coding gaps to help improve collaboration and timely intervention, optimizing quality and performance metrics.
Drive Quality Improvement Across Your Provider Network
- Identify coding and time-sensitive care gaps to improve member care.
- Leverage real-time notifications to enable proactive intervention and care coordination.
- Utilize pre-configured HEDIS specifications to streamline provider follow up and performance monitoring for members that require attention.
Enable Real-Time Collaboration to Reduce Care and Coding Gaps
- Share actionable alerts with providers to address quality/coding gaps and support continuity of care.
- Improve healthcare documentation hand-offs and management.
- Identify and implement process improvement opportunities with your provider network.
Improve Quality and Financial Performance
- Close coding gaps to improve risk adjustment accuracy.
- Enhance tracking and performance on quality scores, including HEDIS and Stars.
- Improve clinical and financial performance by effectively closing care and coding gaps through efficient plan-provider collaboration.
New to Quality and Coding Management: Improve TRC HEDIS Measures
Transitions of Care (TRC) HEDIS measure is the latest upgrade to the Quality and Coding Management solution, providing unmatched insights into transitions of care for health plans. With the TRC HEDIS measure, health plans are empowered to:
- Gain a comprehensive view of a member’s care journey and avoid the pitfalls of fragmented, delayed care information.
- Experience seamless transitions of care with automated clinical documents.
- Enhance continuity of care and improve member satisfaction and care outcomes.
- Take quality of care to the next level with unparalleled visibility into member care transitions.
Interested in Learning More About
Quality & Coding Management?