Dynamic Healthcare Systems Makes Changes to its Risk Adjustment Solution to Meet Regulatory Expansion of Virtual Care
Santa Ana, CA – August 18, 2020 – In the wake of the Centers for Medicare and Medicaid Services (CMS) regulatory changes resulting from the COVID-19 pandemic, Dynamic has updated its Risk Adjustment solution to reflect the expanded definition of qualified telehealth services. Diagnoses resulting from telehealth services can now meet the risk adjustment face-to-face requirement when the services are provided using interactive audio and video telecommunications system that permits real-time interactive communication. Both Dynamic’s Risk Adjustment Processing Systems (RAPS), and Encounter Data Systems (EDS) submissions now include the revised telehealth services qualifications.
Medicare Advantage organizations submitting RAPS and Encounter data to CMS must meet risk adjustment filtering criteria in order to qualify for reimbursement on telehealth services. Dynamic has met this need by making all the necessary changes to filtering logic, filing submission requirements, validations, audit reporting, and user interfaces based on CMS guidance.
“Dynamic Healthcare Systems continues to strive to ensure that all of our managed care clients are compliant in meeting all CMS regulatory changes through all of our solutions, including Risk Adjustment.” Jim Corbett, Chief Strategy Officer.
Dynamic’s robust Medicare Advantage suite of integrated solutions provides health plans and provider groups 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 provider groups meet the complex compliance and data processing requirements that the Centers for Medicare and Medicaid Services 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 was founded in 2005 in response to the significant business and system challenges placed on Medicare Advantage Organizations (MAOs) by the enacted Medicare Modernization Act of 2003.
Dynamic provides an end-to-end automated SaaS solution for health plans and provider groups participating in Medicare Advantage, Managed Medicaid, and Marketplace programs.
Our comprehensive solutions can help Dynamic’s clients optimize revenue and increase the quality of their governmental submissions in an operationally efficient manner that is designed to comply with applicable legal and regulatory obligations. The analytics, integrated workflows, and queues within a single integrated platform help Dynamic’s clients more effectively manage Enrollment, Premium Billing, Revenue Reconciliation, and Risk Adjustment. For more information, visit dynamichealthsys.com or call 949-333-4565 ext. 125.
Phone: 949-333-4565 ext. 180