As the shift to value-based care continues, accurate and timely risk adjustment, which directly impacts both plan revenue and care quality, is becoming increasingly critical to the success of payer organizations. Yet the manual risk adjustment coding process used for first pass, second pass and claims review is time consuming, error-prone and costly. By using NLP-enabled technology to optimize the coder workflow, payers can increase the efficiency and accuracy of their risk adjustment processes, enabling them to identify risk, achieve greater visibility into the true health status of their member populations and improve their financial performance.
During this first in our three-part, NLP-focused webinar series, Shahyan Currimbhoy, Talix’s senior vice president of product management and engineering, will demystify NLP and discuss why and how to integrate NLP into the coder workflow so you can effectively tackle risk adjustment and succeed in value-based care.
Key takeaways include:
- The risk adjustment challenges facing health plans serving Medicare Advantage and commercial/ACA populations, and solutions for overcoming them
- Why high accuracy coding is crucial for risk adjustment success
- What NLP does and how it differs from other new technologies
- The results one plan achieved after adopting NLP-enabled technology to improve their second pass review, including:
– Significant increase in RAF capture
– 3X increase in coder productivity
– Positive impact on risk adjustment ROI