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Quality & Coding Management

Monitor real-time care delivery, quality, and coding gaps to alert stakeholders and optimize quality of care and financial performance.

care managers

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.
A female physician with a stethoscope around her neck and a female executive standing and smiling as they speak with one another

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.
Two skilled nursing facility administrative staff workers seated together with one of them reviewing quality and coding data on a tablet device

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.

Interested in Learning More About
Quality & Coding Management?