Improve risk adjustment for
your health plan

The Innovaccer Health Cloud helps identify coding gaps based on data-driven analytics to
meet your risk adjustment needs.

The Innovaccer Health Cloud for

Risk Adjustment

Identify drop or suspect codes

Analyze historical claims data and clinical documentation to identify
drop codes and suspect codes. Run risk adjustment analytics to
identify diagnosis codes and HCC codes supporting review
outcomes.

Aggregate claims and clinical data

Integrate data into one cohesive application with turnkey tools that extract, aggregate, and normalize data from various clinical and financial systems.

Run analytics for drop suspect codes review

Enable providers to improve coding accuracy with insights on gaps at the point of care. Improve review outcomes with NLP-facilitated coder chart review workflows.

Expand from top 10
HCCs to top 60 HCCs

Identify gaps based on
structural clinical data

Extract data from non-electronic
data files with OCR/NLP

Identify coding gaps at the point of care

Identify coding gaps during outpatient visits with an EMR-integrated
interface. Drive point-of-care prospective review gap closure.

Close Gaps Quickly

Improve care delivery in your provider network by leveraging technology to close HCC coding gaps within data sources.

Measure Provider Performance

Help providers to address gaps with an EMR integration that can push accepted coding changes, track gaps in performance, and create provider scorecards.

Point-of-care
prospective review

Bidirectional EMR communications
to address diagnosis codes

Access clinical data in digital charts

Connect directly with EMR systems for automated access to clinical
data. Bring in structured clinical data and clinical documentation for
downstream risk adjustment needs.

Extract and Process Clinical Data

Utilize prebuilt connectors to directly integrate with EMR systems; capture relevant, historical clinical data; and view updates on member and provider satisfaction.

Access Chart Review Workflows for
Retrospective Review

Close coding gaps with NLP-facilitated coder chart review workflows.

Efficient medical
record retrieval

Retrospective gaps
closure

Enhanced provider
experience

Track risk adjustment performance
over time

View highly customized dashboards with insights on outcomes and
operational metrics.

Business Intelligence

Monitor risk scores and related metrics, such as percentage of members with HCCs, average risk scores, and expected gaps at the member and provider level.

Find Opportunities for Risk Adjustment

Analyze low-performing areas on measures like HCC codes and track operational efficiency metrics.