02-14-2019, 07:08 AM
Medicomp Systems Introduces Automated RAF Scoring Solution to Optimize Medicare Advantage Reimbursement, Increase Efficiency for Physicians
Ground-breaking functionality verifies documentation in real time and identifies potential revenue-impacting gaps
ORLANDO – HIMSS19 CONFERENCE – BOOTH 3901 – Feb 12, 2019—Medicomp Systems, a physician-driven provider of clinically contextual patient data solutions, today announced a new solution to monitor and present hierarchical condition codes (HCCs) at the point of care. This novel functionality, which is powered by Medicomp’s Quippe Clinical Data Engine and Quippe clinical documentation solutions, helps providers participating in Medicare Advantage plans to automate their Risk Adjustment Factor (RAF) scoring to ensure accurate reimbursement.Medicare Advantage plans rely on RAF scores to estimate patient care expenses. RAF scores are calculated using several criteria, including HCCs and clinical documentation. Higher RAF scores drive higher physician reimbursement.
Traditionally providers have lacked automation tools to verify that clinicians are accurately and fully documenting all the information required for correct RAF scoring, which means organizations could be leaving money on the table.
Medicomp’s RAF solution streamlines the scoring process and provides point-of-care dashboard notifications about any conditions that are not fully documented or accurately coded. The award-winning company, which was founded by Peter Goltra in 1978, has long been dedicated to providing solutions that help to improve care and increase efficiency by delivering better data at the point of care. Like other solutions within the Medicomp Quippe suite, this new offering is EHR-agnostic and fully integrates into existing clinical systems to create seamless clinician workflows and a superior user experience.
“To optimize Medicare Advantage reimbursement, health systems and physicians must fully and correctly capture a patient’s condition, including complete and specific documentation for all of a patient’s diagnoses on an annual basis,” said Dave Lareau, CEO of Medicomp. “Until now, most providers have struggled to manually calculate a patient’s RAF score and identify possible gaps in documentation and coding. Our new RAF functionality automates the process and gives physicians critical details in real time so they can make the necessary adjustments in treatment or to documentation.”
Medicomp’s solution automatically reviews patient charts and problem lists in real time to discover HCC-eligible codes. It then prompts users, either at the point of care or retrospectively, with information to verify whether a particular condition is an HCC or related to a possible HCC code. The RAF score is calculated in real time and presented to the user, who is also provided details on any additional documentation or treatment that may be required to ensure accurate risk score calculation.
Meet with Medicomp at HIMSS19 (booth #3901) to learn more about all of Medicomp’s solutions or visit https://medicomp.com/quippe-raf-scoring/ for more information.
About Medicomp Systems
Medicomp Systems pioneered its MEDCIN® Knowledge Engine in 1978. The patented data engine was co-designed with physicians, to transform disorganized, complex arrays of medical information into structured, clinically relevant data at the point of care. Medicomp’s Quippe suite of solutions extend the value of clinical data by delivering rich and actionable insights that transform the delivery of patient care. Longitudinal patient information is available within problem-oriented clinical views, mirroring the way physicians think and work to drive optimal patient outcomes and accurate reimbursement. Quippe’s documentation functionality integrates into existing clinical workflows and EHRs, enhancing EHR usability and fueling advanced reporting and analytics. With Quippe, physicians have ready-access to clean, reliable clinical data that is both patient and diagnosis-specific and provides real value to physicians and patients. Today, leading hospitals and health systems and more than 100,000 users/day rely on Medicomp’s proven domain expertise and clinician-designed technology to improve the quality and efficiency of care delivery. For more information, please visit http://www.medicomp.com/.