Enhancement simplifies diagnosis delete processing and reduces potential RADV risk
Irvine, CA – October 23, 2018 – Dynamic Healthcare Systems, a leading provider of comprehensive solutions to health plans and health systems participating in Medicare Advantage, Managed Medicaid, and Marketplace programs, today announced the release of a new tool for Dynamic’s EDPS solution which simplifies the diagnosis delete process for health plans. The tool gives health plans the ability to identify members and HCCs for a payment year, data mines the CMS EDPS encounter datastore to find all claims attached to that HCC and automatically creates CMS Chart Delete records for review and submission to CMS. The tool allows users to be as broad as an entire HCC for a member or can allow for pinpoint precision to mine and delete specific diagnosis codes at the claim level. The tool supports a simple, flat file input to make processing deletes easy for non-EDI 837 users. The tool automatically formats all required data elements into a submission ready CMS compliant 837 Chart Delete format.
“This new tool, paired with Dynamic’s RAPS to EDPS reconciliation reporting makes identifying and remediating gaps between RAPS and EDPS easier than ever, ensuring the accuracy of member risk scores,” said Lonnie Hardin, Chief Operating Officer at Dynamic Healthcare Systems. This EDPS enhancement will improve reimbursement and reduce potential RADV risk for the health plan,” added Mr. Hardin.
Dynamic’s robust Medicare Advantage suite of integrated solutions provide health plans and health systems with an enterprise-wide platform that enables a strong risk adjustment strategy ensuring maximum and accurate risk-adjusted payments. Dynamic’s integrated software solutions are designed to ensure health plans and health systems meet the complex compliance and data processing requirements that the Centers for Medicare and Medicaid Services (CMS) establishes, monitors, and enforces. Dynamic’s solutions integrate various sources of health plan and provider data to create a single view of a Plan’s membership. This single view facilitates the delivery of high-quality managed care while helping health plans meet compliance and revenue management challenges.
About Dynamic Healthcare Systems
Dynamic Healthcare Systems provides comprehensive solutions to health plans and health systems participating in Medicare Advantage, Managed Medicaid, and Marketplace programs. Dynamic’s solutions help its clients optimize plan revenue and quality through the utilization of Dynamic’s rich analytics that identify areas for potential improvement, help maintain compliance through ongoing enhancements aligned with CMS regulations, and enhance operational efficiency through fully integrated solution utilizing a centralized database and integrated workflows. Headquartered in Irvine, California, the company offers comprehensive software solutions, managed services, and professional services. For more information, visit dynamichealthsys.com or call 949.333.4565.