HCC Analytics

Manage Your Source Data

The Dynamic HCC Analytics solution helps identify missing and miscoded HCC transactions that are reported at the member and/or provider levels. In addition, the Dynamic solution uses the stored data in the RAPS and EDPS Management Module to calculate a forecasted Risk Adjustment Factor (RAF) for each member and provides the capability to reconcile the RAPS and EDS risk scores.  Dynamic can also submit that supplemental information and codes to CMS for proper reimbursement.

Features

• Manage diagnosis data from both qualified and unqualified sources – including claims data, pharmacy encounters, and chart audits
• Detect suspect missing diagnosis codes from historical encounter data
• Calculate RAF scores based on varied collection and cut off dates
• Forecast future CMS payment adjustments to plan revenue
• Quickly enter and validate updated diagnosis codes
• Configure a plan-specific suspecting rules library
• Develop member level suspect lists of missing diagnosis codes and coding errors
• Utilize substantial Report Library through both canned and ad hoc reporting