Outcomes ensures efficient medical records retrieval solutions for accreditation audits and payment integrity projects
If your health plan has been disappointed by work done for a medical records retrieval project or been in danger of missing a deadline for an accreditation audit, then contact Outcomes Health Information Solutions.
Our professional resources are deep and broad. Outcomes delivers diligent service in all 50 states, providing data acquisition and auditing, healthcare analytics and more.
All across the country, Outcomes is built to professionally support the healthcare industry. We can handle the volume: Our national network of field reviewers enables us to collect more than 1.5 million medical records annually. Retrieval isn’t the only service…
Outcomes’ Clinical Audit Team is made up of nearly 300 in-house experienced auditors, nurses and certified coders, who are specifically trained in HCC and other risk adjustment payment methodologies, ICD-9 CM and procedural coding guidelines and accreditation standards such as HEDIS®.
Top quality medical records retrieval key for health plans
When it comes to reading progress notes or interpreting healthcare data, no one does it better than a registered nurse or a certified coder. Medical records retrieval, auditing and analyzing healthcare data is among our specialties.
Outcomes can support your needs, whether your enterprise requires assistance with payment integrity auditing, health advocacy programs and health outcomes improvement initiatives. Our services and products include:
HOI™
HEALTH OUTCOMES IMPROVEMENT
Ensuring Quality Compliance and Rate Optimization
Outcomes can deliver:
- HEDIS® Data Collection and Reporting
- Provider/Group Level Outcomes Reporting
- State and Federal Quality Reporting Initiatives
- Drug Safety and Efficacy Studies
- Disease Specific Audits
- Accreditation Audits
- Credentialing Audits and Site Surveys
- Customized Data Collection and Audit Projects
PIA™
PAYMENT INTEGRITY AUDITING
How Healthy Is Your Providers' Coding?
This line of service includes:
- CMS HCC Risk Adjustment - "suspect identification" or chart identification for prospective and retrospective activities
- Medicaid Payment Compliance Audits
- Evaluation & Management Audits
- RADV (Risk Adjustment Data Validation) Audit Support
HAP™
HEALTH ADVOCACYPROGRAMS
Creating Personal Connections With Your Members
This type of member outreach service includes:
- Three-way Call, Provider Appointments
- New Member Welcome Programs
- Health Risk Assessments
- Member Retention/Member Re-certifications
- SNP Programs and Initiatives
- Prevention and EPSDT Outreach
- Disease Management Support Services
- HEDIS® Member Outreach
- Care Gap Outreach
- Health Care Reminder Calls
- Customized Member Outreach Programs