Helping you capture the full value of patient encounters

RiskSight Retro

PopHealthCare provides a balance of prospective and retrospective interventions to optimize our clients’ program investments. RiskSight Retro combines our chart-targeting analytics and prioritization and focuses on maintaining a greater ROI for our clients by maximizing successful chart retrieval and by uncovering new and incremental Hierarchical Condition Categories (HCCs).

Chart Retrieval

  • Electronic and physical chart retrieval
  • Our dedicated schedulers identify the most convenient methods and times for obtaining medical charts
  • Our imaging technicians go onsite to provider offices, outpatient clinics, EMR administrative offices and hospitals
  • Our provider-friendly approach uses a digital camera attached to an encrypted laptop for quick and minimally disruptive capture of medical records
  • Our project management processes include quality assurance, online operational reporting, and health plan coordination to improve project transparency and success
  • We maintain ten-year digital record retention

Coding

  • Properly documented diagnoses are identified and coded by our certified coding staff. They are equipped with extensive training in ICD-9 based risk adjustment models and with additional training on ICD-10 models
  • Our technology allows coders to quickly and permanently tie chart documentation to the HCCs identified, expediting coding, quality reviews and validation audits
  • We maintain a minimum accuracy standard of 95% and strive to exceed this benchmark through extensive ongoing training and quality oversight

Market & Project Specific Variations:

  • Chart collection windows and submissions timelines
  • Allowed dates-of-service
  • Member enrollment spans and relevance to risk adjustment
  • Risk adjusting diagnoses (e.g. CMS HCC, HIX HCC)
  • Required staff credentials
  • Tie-outs to claims data

Getting Started

Contact us today for a free consultation and analysis of your data.