White Paper:

Improving Patient Care and Revenue Integrity with a Pre-Encounter Risk Capture Solution

Patient-Centered Risk Capture Workflow

Pre-Encounter: ID ..... During-Encounter: Documentation ..... Post-Encounter: Coding
Pre-Encounter:
Identification
During-Encounter:
Documentation
Post-Encounter:
Coding




The challenge in most provider organizations is that they have been set up for success to operate within a fee-for-service model. Many lack the infrastructure, knowledge, and resources to manage requirements in risk-sharing arrangements. 


An effective patient-centered workflow should be established that is supported by appropriate technology, people, and processes where each phase is treated as an important component to establishing a successful risk capture program.



View our Risk-Bearing Provider Solutions



Supporting Care and Accurate Risk Profiles without Administrative Burden

The move toward value-based care – and, therefore, risk sharing among provider and payer organizations – continues to gain steam. As such, more provider organizations than ever before are participating in risk sharing contracts, but success hinges on their ability to manage and adjust risk.

Risk is often seen as an administrative element of healthcare, separate from clinical work. However, the right technological support can help physicians more readily address chronic conditions through clinical suspecting delivered via NLP and confirmed via clinical review specialists. This improves care and delivers a more complete and accurate risk score without adding an additional non-clinical burden to providers.

Key Takeaways:

  • Risk adjustment workflows deployed before and after point of care minimize physician burden
  • Pre-encounter risk adjustment addresses missed and under-diagnosed conditions
  • Technology-driven risk workflows support coder teams and their expertise
  • In addition to more targeted care, pre-encounter risk adjustment provides a strong, reliable ROI

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