Risk Adjustment and
Revenue Management Experts
Professional, Innovative, Results Oriented…
A Medicare Advantage health plan’s financial performance is driven by its ability to successfully manage and submit risk adjustment data to the Centers for Medicare and Medicaid Services (CMS). PopHealthMan was created to work directly with health plans to ensure this process is done accurately and efficiently. At PopHealthMan, you’ll find inventive solutions for Medicare Advantage risk adjustment that incorporate complete data management, the extensive review of medical records, and inclusive analytics to quickly advance your health plan’s performance. We’re dedicated to providing health plans and providers participating in the Medicare Advantage program with our comprehensive services and pride ourselves on our professional, innovative, and results oriented method. Start optimizing your revenue today with expert services from PopHealthMan!
Our Method for Success
Using our expertise, years of experience and proprietary algorithms, we quickly analyze Medicare Advantage health plans’ risk adjustment data and provide an accurate assessment with results and identified opportunities for improvement. In order to do this we use an innovative method that includes:
- Free Analysis of Health Plan Risk Adjustment Data
- Initial Review and Process Improvement Consulting
- Risk Adjustment Processing System (RAPS) Creation and Submission
- HCC Suspect Identification
- Comprehensive Medical Record Retrieval
- Diagnosis Coding and Chart Review
- Provider Documentation and Assessment of Potential Interventions
- Complete Metrics Reporting and Financial Impact Analysis
Our extensive and innovative methods enable us to successfully document disease burden through RAPS submissions, offer efficient and effective medical record reviews, and present imperative insight on financial forecasting and the risk adjustment process.
We take the security issue of document retrieval and review seriously, and use only the most stringent techniques to fully comply with the regulations. The retrieval, transmission, and storage of medical records are completely discreet and reliable.
Devoted to Advancing Performance
Our top priority at PopHealthMan is advancing the overall performance of Medicare Advantage health plans through our groundbreaking processes. We are devoted to providing those we work with an accurate report and submission of their Medicare Advantage risk adjustment data, ensuring CMS compliance. We are the preferred vendor for the Association of Community Affiliated Plans (ACAP), and maintain solid relationships with clients in nine states and Puerto Rico. Contact us today and get a free analysis of your health plan risk adjustment data to identify your potential revenue opportunity!
