Concord helped our client build the tools and processes necessary to save time and administrative effort in their risk adjustment process. First, our team created a data ingestion process to convert provider data to an acceptable CMS format from historical and ongoing data sources. This process provides reporting and generates EOBs for supplemental benefit vendor data. Once the data was in place, we developed a UI tool to extract value for business users. The UI reviews data from different providers and compiles it into one central location. Users can use the UI tool to match submissions and responses to a list of all records with errors provided by CMS. Correcting and re-sending data to CMS has never been easier.
With a new data ingestion process and UI tool in place, the business is able to continuously monitor and improve on a process that was once entirely manual. Our client was able to improve the completeness of Supplemental Benefit Vendor encounter submissions from 93% to 98.5% while reducing the overall cost of labor per year.
The new system ultimately helps the business:
- Share Supplemental Benefit Vendor encounters and provider diagnostic data to CMS
- Stay in compliance with timely reporting
- Encourage proactive management of submission errors