3^rd Annual Risk Adjustment Innovations Forum

CoventBridge Group has more than 25 years of experience in the identification, prevention and investigation of fraud, waste, and abuse for our customers across the healthcare, insurance, financial and government markets with a proven track record of implementing and managing the largest programs in industry.

With a national employee investigator network and expertise in Medicare and Medicaid, CoventBridge Group has a singular focus in service offerings to fight fraud, waste and abuse.
For more information, visit    Health Plan FWA Solutions | CoventBridge

BeneLynk is a national provider of Social Determinants of Health (SDoH) solutions for Medicare Advantage and Managed Medicaid health plans. We serve plans and their members by creating a human-to-human connection and providing the assistance a member needs to get the benefits they deserve.

By employing one dynamic conversation that flows organically to meet SDoH challenges, we build stronger human connections that are supported by innovative technology.  Our mission is to improve lives and positively impact SDoH barriers by providing our healthcare partners with the information they need, and people with the advocacy they deserve.

Founded in 2003, ATTAC Consulting Group (ACG) has been recognized as a premier national consulting and auditing firm serving insurers, managed care and provider organizations on issues related to Medicare Advantage, Part D, Medicaid, Duals Programs, ACOs and Health Exchange products. ACG specializes in regulatory compliance, auditing, operations and business process, along with medical and pharmacy management. ACG also provides Network Development for nationwide builds and support to maintain the accuracy of your provider data. ACG has delivered solutions and provided support for many of the nation’s top 10 insurers, along with Blue’s organizations, regional health plans, special-needs organizations, specialty insurers, health systems, ACOs, drug plans and the regulatory agencies that oversee the industry. At ACG, we’re passionate about our industry and passionate about getting it right. We’re proud of our reputation among industry leaders to perform detailed operational analyses and to design and deliver rock-solid end-to-end solutions. Our clients count on ACG to provide expert regulatory advice, to implement robust compliance solutions and to perform efficient, expert auditing. Our medical and pharmacy groups are guiding organizations in adoption of new models to manage care in a cost-effective way.

Veradigm is a healthcare technology company that drives value through its unique combination of platforms, data, expertise, connectivity, and scale. The Veradigm Network features a dynamic community of solutions and partners providing advanced insights, technology, and data-driven solutions, all working together to transform healthcare insightfully. For more information on Veradigm, visit  http://www.veradigm.com , or find Veradigm on  LinkedIn , Facebook , Twitter , and  YouTube.

The Wolters Kluwer Health Language platform ensures that anyone who relies on healthcare data can trust that it is accurate and fit-for-use. With the most robust data, AI-enabled technology and decades of experience working in healthcare, the Health Language platform ensures that the quality of your data is maintained to meet your needs, because good data powers better health. Leveraging a curated and continuously updated library of industry standards, organizations can maintain a single source of truth for their healthcare data, which can be easily accessed in the cloud. This trusted terminology foundation serves as the benchmark for managing all codes throughout the data value chain and helps identify and maintain relationships across data sets. From point of care documentation to data normalization, analytics, and risk adjustment, healthcare data is messy. Health Language can clean it up, ensuring that good data powers better health.

Milliman IntelliScript is the leading creator of risk-assessment insurtech for the U.S. life and health insurance sectors. Our actuaries, clinicians, developers, and data scientists combine deep technical expertise and a pragmatic focus on demonstrable ROI. We invent and relentlessly improve data-driven SaaS solutions to help carriers make better decisions faster and with greater confidence. For over 20 years now, our customers have come to know us as category-defining innovators and reliable strategic partners. They count on us to clarify both risks and opportunities—so they can see more and fear less.

Want to improve Risk Adjustment coding speed and accuracy, minimize risk of coding errors, and boost productivity and efficiency? Consider HCC Coder™ - the only software available for Risk Adjustment coding that was built from the ground up by medical coders, for medical coders. HCC Coder boosts productivity and efficiency using an interface that is intuitive; one that has been refined to move step-by-step along with your coding/auditing process. It’s packed with all of the content you need and eliminates everything else. You won’t have to wade through irrelevant information to find the Hierarchical Condition Category codes most relevant to your work.

Fathom is the leader in autonomous medical coding, applying cutting-edge deep learning to produce complete risk-adjustment coding with zero human intervention. Our AI technology reduces costs, increases accuracy and specificity, strengthens revenue capture, and shortens turnaround times from days to minutes. We carry out a risk-free trial to demonstrate our coding quality before your organization ever pays us a dollar.

Pareto Intelligence is an analytics and technology solutions company that supports healthcare plans and providers with revenue, cost, quality, and risk adjustment payment models. Pareto was forged to help our clients navigate the most dynamic and critical times in healthcare, and we continue to bring innovative solutions to meet unmet market needs. Pareto acts as a trusted partner, helping clients make key decisions with big data analytics, easy-to-use technology, and expert advisory support. Our award winning suite of technology solutions and services help our clients harness the power of data science and develop actionable insights. We show you what to do with the insights you've acquired and give you direction for tomorrow.

RAAPID transforms complex healthcare data into actionable insights using Clinical AI and VisionAI technology. Our platform helps healthcare organizations unlock trapped value in unstructured data, converting complex clinical documents into structured, actionable insights. Purpose-built for healthcare and one soft-approved by RADV auditors, we process millions of patient records to help ACOs, providers, and health plans maximize accurate reimbursements while reducing provider abrasion.

At Annova Solutions, we empower healthcare payers, particularly Medicare Advantage plans, to optimize performance and achieve superior outcomes. With expertise in V28 coding, concurrent coding, and AI-driven solutions, we help organizations improve financial accuracy, elevate data quality, and ensure regulatory compliance with ease. We enable healthcare payers to enhance the member experience, boost Star Ratings and achieve operational excellence. Our focus on efficiency and quality improvement equips Medicare Advantage plans with the tools and expertise needed to drive better financial performance, maintain compliance, and achieve long-term success.

The Persivia CareSpace® Platform stands out as an integrated, AI-driven solution tailored to support all VBC models and care venues to help payers and providers excel in VBC. CareSpace® merges clinical, socioeconomic, claims and other data from multiple sources to provide a single comprehensive picture that puts the patient at the centre of care. It offers advanced analytics, real-time clinical decision support, and valuable insights at the point of care to help improve care quality and reduce costs. CareSpace® offers a comprehensive view of both individual patients and broader populations, ensuring personalized and cost-effective management. At the core of our capability lies our expertise in using Artificial Intelligence to provide Care Management, Risk Adjustment, STARS Management, Cost and Utilization Management and Risk Stratification capabilities. The foundations of Persivia Inc. are deeply rooted in over a decade and a half of experience in developing and launching an AI-centric Population Health Management platform. Today, we proudly support care, quality, cost and risk management initiatives in over 200 hospitals, with a user base of 12,000 clinicians. Founded in 2015, Persivia Inc. is headquartered in Marlborough, Massachusetts,www.persivia.com

healow® is a comprehensive, EHR-agnostic, cloud-based platform for patients, practices, payers, hospitals, and health systems. healow provides Patient Relationship Management, clinical and payer insights, and state-of-the-art interoperability solutions. The PRISMA health information search engine gathers patient records from other EHRs and helps providers focus on the most clinically relevant information at the point of care. healow’s Population Health Management tools, including Remote Patient Monitoring, provide real-time data to deepen understanding of patient populations. And healow Insights automates the bidirectional exchange of data between health plans and providers to improve scores on quality measures, help control costs, and promote better medical outcomes. Learn more at  www.plus.healow.com.