Comprehensive Risk Adjustment Services Extends Capacity for Government-Sponsored Healthcare Programs
Irvine, CA. – December 15, 2015 —Dynamic Healthcare Systems, a provider of enterprise technology solutions for government-regulated health plans, today rolled out its Risk Adjustment Management Program (RAMP), designed to assist health plans participating in Medicare, Medicaid and Exchange lines of business. Dynamic’s RAMP, combined with technical expertise from its resident Subject Matter Experts (SMEs), provides a comprehensive program that supports a health plan’s Risk Adjustment department. The program focuses on three primary areas: CMS overpayment analysis, HCC opportunity analysis and revenue optimization.
“Dynamic deeply understands the challenges that government-regulated healthcare plans face,” said Kathy Feeny, President and Chief Executive Officer of Dynamic Healthcare Systems, Inc. “Dynamic’s RAMP provides health plans with much needed capacity and extended capabilities, as well as access to highly knowledgeable SMEs and detailed analytics to make their Risk Adjustment strategies more effective and efficient,” Feeny added.
With a robust RAMP solution from Dynamic, government-regulated health plans gain access to expert analysis, using intelligent analytics, to forecast and optimize revenues from CMS. Analytics from the program uses submitted RAPS and EDPS data to show plans their risk adjusted forecast revenue based on their current score versus their future score. In addition, RAMP experts identify the members and providers impacting plan revenue the most. Key features of RAMP include:
- Strategic planning and monthly assistance with accomplishing program goals and objectives
- Monthly work plans and target lists for member and provider outreach and intervention
- CMS Payment Analysis that includes identification of potential overpayments, reverse suspecting and reviews of problematic claims such as lab, x-ray, blood draw claims, etc
- HCC Opportunity Analysis that includes clinical analytics targeting missing HCC diagnosis, RN clinical review of client specific data, and suspect targeting and prioritization
- Revenue Optimization that includes detailed identification of priority suspected diagnosis clusters to be reviewed, along with support to develop chart review strategy, including priority HCC targeting
- Financial results reporting to track which initiatives are contributing the most to HCC collection efforts
Dynamic’s integrated software solutions are designed to ensure health plans meet the complex compliance and data processing requirements that the Centers for Medicare and Medicaid Services (CMS) establishes, monitors and enforces. Dynamic’s software integrates the various sources of data to create a single view of a Plan’s membership in order to deliver high-quality managed care and consistently meet compliance requirements as well as address revenue management challenges.
About Dynamic Healthcare Systems
Dynamic Healthcare Systems, Inc. delivers comprehensive enterprise software solutions and services for health plans with Medicare Advantage, Medicaid, and Marketplace lines of business striving to succeed amid new and evolving regulatory requirements. Headquartered in Irvine, California, the company brings world-class innovations to companies serving the government-regulated healthcare population. For more information visit dynamichealthsys.com or call 949.333.4565.