Revenue is the Result of Quality
CVInfosys’ Medicare Risk Adjustment solutions make financial sense of CMS files and provide intelligence, predictive modeling, and tools for proactive medical care and CMS revenue projections.
Medicare Advantage plans and providers know that right-sizing CMS reimbursements is critical in this climate of decreasing Medicare Advantage rates. Plans and providers must continually improve their process for both capturing and submitting only properly documented ICD-9 codes, while recalling codes discovered to be inadequately supported within the Medical Record.
CVInfosys’ tools help to right-size CMS revenue throughout the course of the year. When deployed at a plan or provider level, RevenueMax™ yields proactive intelligence that prioritizes and targets suspects for data pursuit, initiates new member outreach, supports case management, and optimizes resource personnel.
CVInfosys regularly partners with clients to analyze their CMS reimbursement issues and HCC data operations. As a result, CVInfosys is often able to help clients discover where data and revenue leaks may be occurring, and supports timely, corrective action before a CMS collection period closes. By providing Risk Adjustment data pursuit services (DxMax™, MDMax™) and data analytic/correction tools (RevenueMax™, SubmissionMax™), CVInfosys helps clients experience less revenue drop-off, allowing them to channel more resources to back into health care.