Overview
Our Provider Services Capability delivers end-to-end support across the provider value chain, from patient access and prior authorization to RCM, clinical documentation improvement (CDI), coding, HEDIS, HCC coding, RAF (Risk Adjustment Factor) optimization, quality reporting, compliance, and audits.More
Our Provider Services Capability delivers end-to-end support across the provider value chain, from patient access and prior authorization to RCM, clinical documentation improvement (CDI), coding, HEDIS, HCC coding, RAF (Risk Adjustment Factor) optimization, quality reporting, compliance, and audits. Powered by advanced AI and deep healthcare domain expertise, we reduce administrative burden, improve accuracy, strengthen compliance, and accelerate financial and value-based performance, while enhancing patient and clinician experience.
LessOur Offerings
Accelerated Patient Access and Onboarding
Faster access. Fewer errors. Better patient experiences.
Accelerate Patient Access with seamless digital onboarding, real-time insurance checks, smart scheduling, and automated reminders for fewer no-shows.
Autonomous Clinical Coding
Higher accuracy. Faster turnaround. Stronger compliance.
Harness advanced NLP and machine learning to improve coding precision, accelerate throughput, and ensure accurate, compliant documentation that supports quality reporting and revenue integrity.
Insightful Denial Management
Predict denials. Protect revenue. Accelerate cash flow.
Leverage predictive insights and targeted workflows to identify denial risks early, prevent avoidable denials, and resolve issues faster, reducing rework and improving reimbursement timelines.
Proactive Risk and Compliance Alerts
Identify risks early. Stay compliant. Safeguard performance.
Gain real-time visibility into clinical, operational, and compliance risks, enabling proactive intervention before issues escalate into audits, penalties, or revenue loss.
HEDIS and Quality Measure Management
Close care gaps. Improve quality scores. Strengthen performance.
Enable accurate HEDIS abstraction, measure calculation, and gap closure to improve quality outcomes, support value-based programs, and enhance payer and regulatory performance ratings.
HCC Coding and RAF Optimization
Capture clinical complexity. Optimize risk scores. Protect revenue.
Ensure accurate and compliant HCC coding and RAF optimization through comprehensive chart review, suspect identification, and documentation alignment; supporting fair reimbursement and audit readiness.
AI and Automation Accelerators
Business Impact
- Accelerate patient onboarding by up to 90%
- Achieve up to 99% accuracy in denial prediction and handling
- Reducing claim denials was 40-70%
- Lower operational costs by 30-50%
Drive up to 30% faster risk adjustment, improve coding accuracy by 20%, and boost quality measure compliance, delivering millions in revenue uplift and reduced audit risk.
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