Apicare Insights: AI-powered condition suspects
Risk adjustment teams face internal financial pressure and growing regulatory pressure to move away from retrospective chart reviews for Medicare Advantage. To facilitate more accurate risk capture upstream, many organizations are implementing prospective programs that equip physician offices with information to improve condition coding, support closing care gaps, and develop a more holistic view of patient health. But developing an accurate, actionable list of diagnosis gaps and measuring performance is time-consuming and complicated.
Apixio’s Apicare Insights solution uses high-precision AI algorithms to generate a list of suspected patient conditions that haven’t been captured on claims, powering your prospective program with reliable intelligence using existing workflows. The Apicare Insights Dashboard provides insights on program performance over time.