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6.0 Highlights
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HCC Helper 1.0
 HCC Helper also tells you the additional codes (codes manifestation) you need while coding a particular ICD9. For instance while coding 250.4, you also need to code 581.81, 583.81 etc. HCC Helper is available FREE for iPhone users.
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Customer Speaks
 The technology employed to create our secure dashboard simplifies our ability to conduct reconciliations and avoid missed opportunities. Congratulations to Storan on this impressive upgrade! Kathy Cortez Vice President, Operations Fidelis SeniorCare |
RAPS
RAPS Submission, CMS Sweep Deadlines, Chart Reviews, Audit, RAPS Generation
The Medicare risk adjustment payment system uses clinical coding information (HCCs) to calculate risk premiums for Medicare Managed Care Organizations (MCOs). The CMS Medicare reimbursement system is fairly complicated and requires the MCO to be able to monitor historical, current and future data, claims, in time RAPS Submission for each CMS sweep, Retrospective and prospective audits and RAPS generation in order to determine reimbursement. Medicare Advantage Plan Data Management and Risk Adjustment process in itself does nothing to maximize your Medicare reimbursement, it simply allows you to monitor and hopefully estimate your future and mid year payments. In order to maximize your Medicare reimbursements you will need to conduct three other activities:
The bottom line is, that even if a plan has a sound knowledge of the reimbursement process, it will require significant effort and efficient tools to generate a positive impact on CMS reimbursement.
Relying on a trusted vendor for these technological and administrative aspects allows you to focus on your core competencies: marketing and enrollment, educating providers on new programs and community outreach. STORAN offers all the necessary technology out of the box freeing up your valuable IT resources. Their comprehensive Medicare Risk Adjustment software provides you with everything from automated Health Risk Assessments thru financial performance and modeling and everything in between. It is no wonder that they have processed over two point eight million charts reviews. STORAN can provide you the exact solutions you need to maximize your plans’ Medicare Advantage reimbursement
Storan Technologies Inc., offers wide range of Medicare Risk Management services to Medicare Advantage Plans around United States. Storan Technologies Medicare Risk Management product is known as Merlin Medicare Risk Adjustment. Medicare Advantage Plans utilize Merlin Medicare Risk Adjustment for:
Merlin Risk Adjustment is also available in desktop version for retrospective audits. It can work without internet connectivity. It only requires internet connectivity for synchronization with Storan secure data servers in order to retrieve and post retrospective audit data
Call us today at 636.477.7701 option 1 to find out how you can implement a HCC Management system in as little as four days or for a live demo of Merlin Risk Adjustment
The Medicare risk adjustment payment system uses clinical coding information (HCCs) to calculate risk premiums for Medicare Managed Care Organizations (MCOs). The CMS Medicare reimbursement system is fairly complicated and requires the MCO to be able to monitor historical, current and future data, claims, in time RAPS Submission for each CMS sweep, Retrospective and prospective audits and RAPS generation in order to determine reimbursement. Medicare Advantage Plan Data Management and Risk Adjustment process in itself does nothing to maximize your Medicare reimbursement, it simply allows you to monitor and hopefully estimate your future and mid year payments. In order to maximize your Medicare reimbursements you will need to conduct three other activities:
- Retrospective Audits
- Prospective Audits
- Provider Education
The bottom line is, that even if a plan has a sound knowledge of the reimbursement process, it will require significant effort and efficient tools to generate a positive impact on CMS reimbursement.
Relying on a trusted vendor for these technological and administrative aspects allows you to focus on your core competencies: marketing and enrollment, educating providers on new programs and community outreach. STORAN offers all the necessary technology out of the box freeing up your valuable IT resources. Their comprehensive Medicare Risk Adjustment software provides you with everything from automated Health Risk Assessments thru financial performance and modeling and everything in between. It is no wonder that they have processed over two point eight million charts reviews. STORAN can provide you the exact solutions you need to maximize your plans’ Medicare Advantage reimbursement
- Comprehensive in depth financial analysis like revenue forecasting, delayed and lost revenue and revenue history at member and plan level
- Identify charts and physician for retrospective audits using a comprehensive suspecting engine based pharmacy, missing HCCs and ICD9 based statistical rules
- Detailed chart history of each individual with details like ICD9, Date of Service, Part C HCC, Part D HCC, Factor Value and Provider who diagnosed it with a single click
- Comprehensive Retrospective audit tools available to Schedule, Track and Manage the complete process of retrospective audit
- Reports to monitor Retrospective audit and its financial impacts for Plan
- Comprehensive Provider Education Reports
- Automated RAPS generation process aided with de-duplication, identification and correction of RAPS errors
- Fully encrypted and secure file sharing and data transfer
- All reports are easily exportable to Excel and PDF
Merlin Risk Adjustment is also available in desktop version for retrospective audits. It can work without internet connectivity. It only requires internet connectivity for synchronization with Storan secure data servers in order to retrieve and post retrospective audit data
Call us today at 636.477.7701 option 1 to find out how you can implement a HCC Management system in as little as four days or for a live demo of Merlin Risk Adjustment
