For Medicare Advantage Plans seeking to assure that they close all the care gaps and maximize reimbursement, Risk Adjustment data submission and analytics play an important role. At Health Data Max, we ingest your claims data and provide meaningful insight. We will certify your data submissions to CMS MARx portal on your behalf to ensure reimbursements are maximized. Our advanced analytics engine tracks quality care gaps, identifies high-chronic patients, and reports on more common errors so your data can be corrected at the source, resulting in a high acceptance rate of your data files. We track each stage of EDS submission & response files (999s, 277s, MAO-002s, MAO-004s, MORs and MMRs) so you have a complete picture of your submission at your fingertips.
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Post-submission, our advanced analytics renders reports at Member and Provider level risk scores through advanced CMS-driven HCC risk models. You have absolute visibility in managing the performance of providers to ensure accurate & compliant chronic diagnosis capture and reporting.
Some of the common reports we provide:
1. Tracking of EDS 999, 277 and MAO-002 submissions
2. Report on risk-score by member & provider
3. Report on high-chronic patients with care gaps.
As it is quoted very often - top 3% of chronic patients drive up to 50% of costs. Prioritize your submission errors so your efforts are focused on better patient care.
Know more about Medicare Advantage Risk Adjustment Data Submission Requirements to CMS.