Our Analytics Suspect What CMS Suspects
CVInfosys is unique because it has deep, in-house expertise in Compliance (for Medicare and HIPAA) in addition to Risk Adjustment. All tools and services meet rigorous standards for supporting all aspects of security and compliance.
Additionally, CVInfosys provides Medicare Advantage health plans with RADV Readiness support. Simply put, RevenueMax™ suspects what CMS suspects.
As CVInfosys clients move from retrospective chart reviews to a more proactive approach, RevenueMax’s™ Risk Adjustment analytics can direct their efforts to conduct internal audits. The tool can identify outliers and single occurrences of HCCs, as well as reveal patterns in coding that may require scrutiny.
Additionally, CVInfosys can help plans build more valid HCC data sets by pursuing under-reported ICD-9 codes from inpatient stays (DxMax™). Statistically, hospital coding has been found to be more accurate than codes reported from physician sites of service, thus DxMax™ hospital data collection services can offer RADV “insurance” when plans seek the best possible record to substantiate an HCC.