Revenue Enhancement
Providing Quality Care to the Chronically ill Should be Rewarded.
With the establishment of risk-adjusted payments for Medicare Advantage members, and in many states for Medicaid as well, it is important to maximize the capture of all encounter and complete diagnosis information. INSPIRIS’ multifaceted clinical and coding assessments provide a complete and thorough coding that is validated to help improve quality of care while optimizing health plan revenue. Conducted at home or in a facility, assessments weigh each patient’s physiological, psychosocial, behavioral, functional and environmental needs. This clinical and diagnostic assessment determines the patient’s risk score, the optimal level of care and care plan.
Risk-adjusted payments allow plans to be paid more appropriately for members with more complex medical needs. Through increased revenue from optimized coding, resources are available to offer better care to this underserved population.