Intelligent Technology and Professional Services You Can Trust
The Intelligent Technology and Professional Services You Can Trust
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RISK ADJUSTMENT FACTOR (RAF) CHALLENGES:
- Hospitals and providers with Medicare Advantage plans and ACOs struggle to be paid accurately based on RAF scores.
- There is a need to improve Risk Adjustment Factor (RAF) scores to reflect the health status of their population accurately and compliantly.
- Simply combining known Hierarchical Condition Categories (HCCs) in a way that drives higher reimbursement based on artificial, and non-validated patient complexity will absolutely fail during an audit and will result in liability to the MA plan or at-risk payor.
- Annual Wellness Visits (AWV) are extensive, and providers struggle with having enough time to complete MA plan/ACO requirements related to the re-documentation of diagnoses. This can negatively impact the accuracy of the RAF score.
- Provider Education and reliance on current Electronic Medical Record (EMR) technology is simply not enough nor effective in assisting providers to perform and complete past and current patient conditions assessments resulting in marginal improvement with re-documentation rates and RAF scores.
- Resistance to innovation impedes organizational change and results in less that favorable results.
- Competing RAF solutions rely on educating the provider through seminars, webinars, lunch and learns and video training combined with EHR historical queries and reference sheets for the provider to utilize during an annual wellness visit with the patient. This results in a generalized trigger-based patient assessment but does not provide the depth of information needed to complete a customized and comprehensive approach to the assessment.
- CareLync’s exclusive compliance focused intelligent retrieval technology utilizing hundreds of surveys and processing rules ensures a personalized relevant patient assessment that is accurate, comprehensive, and compliant.
- CareLync combines known Hierarchical Condition Categories (HCCs) in a way that compliantly drives higher reimbursement based on validated patient complexity and is the key to successful audits and this mitigates the liability to the MA plan or at-risk payor.
- CareLync’s comprehensive RAF compliance optimization technology covers all four of the required steps to validate and compliantly document diagnoses driving increased audit validation and success.
- CareLync’s innovative approach to RAF compliance and optimization has swiftly gained acclaim as one of the most effective solutions for healthcare administrators and providers. Embraced by providers, our solution not only saves significant time for the reviewing practitioner, but also ensures fiscal accuracy revenue capture, earning strong endorsements from corporate suite administrators.
CareLync Provides the REAL Actionable Solutions that Provide REAL Results
- Competing RAF solutions rely on educating the provider through Seminars, Webinars, Lunch and Learns and video training combined with EHR historical queries and reference sheets for the provider to utilize during an annual wellness visit with the patient. This results in a generalized trigger-based patient assessment but does not provide the depth of information needed to complete a customized and comprehensive approach to the assessment.
- CareLync’s exclusive compliance focused intelligent retrieval technology utilizing hundreds of surveys and processing rules ensures a personalized relevant patient assessment that is accurate, comprehensive, and compliant.
- CareLync Combines known Hierarchical Condition Categories (HCCs) in a way that compliantly drives higher reimbursement based on validated patient complexity and is the key to successful audits and this mitigates the liability to the MA plan or at-risk payor.
- Carelync’s comprehensive RAF compliance optimization technology covers all four of the required steps to validate and compliantly document diagnoses driving increased audit validation and success.
- CareLync’s innovative approach to RAF compliance and optimization has swiftly gained acclaim as one of the most effective solutions for healthcare administrators and providers. Embraced by providers, our solution not only saves significant time for the reviewing practitioner, but also ensures fiscal accuracy revenue capture, earning strong endorsements from C-Suite Administrators.
How We Support You
Care Lync currently supports the following programs, services and waivers in Pennsylvania within the Office of Long-Term Living (OLTL) and Office of Developmental Programs (ODP)
- Community Living Waiver
- Consolidated Waiver
- OBRA Waiver
- Person/Family Directed Support PFDS Waiver (PFDS)
- Program Exception
We’re More Than Service Coordinators, We Are Advocates.
- EMPOWERMENT: We empower our Participants to lead exceptional lives and reach their maximum potential.
- INDEPENDENCE: Our mission is to provide solutions for each of our Participants that allow them the independence they need to live a fulfilled life.
- CHOICE: We educate each of our Participants about the choices available to them to be sure they get the services they want.
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ADDITIONAL BENEFITS INCLUDE
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- Improved Patient Engagement, Patient Experience, and Service by leveraging best-in-class technology to communicate directly with patients (white labeled as an extension of the physician practice). This proactively engages patients to address any identified gaps and to ensure the overall care experience meets and exceeds patient expectations.
- Increased Quality of Care and Improved Care Outcomes by directly assessing and highlighting gaps in care at the individual patient level as required by CMS. These measures are national standards directly linked to patient diagnosis, nationally adopted, proven clinical workflows, and best practice clinical intervention and treatment.
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- Enhanced Financial Stewardship through full realization of revenue earned by closing care gaps, documenting appropriately for all care provided, and proactively capturing quality care bonuses while avoiding revenue penalties. This enhanced financial stewardship posture results in substantial economic benefits for provider groups that engage in our services by reducing cost and increasing margins through increased efficiencies.
- Provider Well-being and Support by offering our Virtual Support National Network (including fully vetted and credentialed Nurse Practitioners, Physician Assistants, and Medical Assistants) as a natural extension of your practice to provide the resources necessary to close all patient care gaps without the practice having to recruit, hire, train and retain additional staff members at a much higher human capital cost.