Quality and Coding Management
Monitor real-time care delivery and quality gaps to alert stakeholders and optimize quality of care and financial performance.
Our Quality and 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.
Introducing your Transitions of
Care (TRC) Solution
Improve performance on the TRC measure and boost your CMS Star Ratings through seamless access and exchange of discharge data between payers and providers.
- Gain access to real-time admission notifications and timely discharge data to meet time-sensitive specifications.
- Eliminate manual processes and reduce administrative burden by leveraging native payer and provider workflows for data access.
- Close quality gaps and reduce avoidable readmissions.
Interested in Learning More About
Quality and Coding Management?