Proactive Risk Capture and Gap Closure with Prospective Risk Adjustment
Predict, prepare, and perform—transform risk adjustment from reactive to strategic with AI-driven pre-visit insights.
Turn Predictions Into Performance
By shifting risk adjustment upstream, we turn what was once retrospective guesswork into proactive precision, ensuring no revenue opportunity slips through the cracks. This isn’t just gap closure—it’s gap prevention. By acting on pre-visit insights, you’re not just capturing risk; you’re redefining it.
Health Ovations’ Prospective Risk Adjustment leverages predictive analytics and clinical intelligence to flag undocumented conditions before patient visits. By arming providers with targeted member profiles and suspect conditions, we drive net-new HCC capture, improve care quality, and future-proof your program against compliance risks—all while optimizing revenue potential.
Features
Identify Suspect Conditions Early
Uses predictive analytics to flag undocumented chronic conditions before member visits for proactive capture.
Support Pre-Visit Planning
Delivers targeted member profiles to providers, ensuring focused and efficient encounters.
Increase Net-New HCC Capture
Uncovers incremental risk drivers to maximize RAF accuracy and revenue potential.
Enhance Member Quality of Care
Future-Proof Your Program
Data-Driven Insights
Facilitates early interventions by identifying gaps in care and chronic conditions ahead of visits.
Strengthens compliance and accuracy to minimize audit risks and ensure long-term sustainability.
Leverages advanced analytics to prioritize high-impact opportunities for risk adjustment and care improvement.
Benefits
Prospective Risk Adjustment doesn’t just improve accuracy—it transforms how you capture risk, deliver care, and protect revenue.
Predict Risk, Prevent Leakage
Catch suspect conditions early with high prediction accuracy, reducing post-visit coding gaps and revenue loss.
Quality Care Meets Quality Data
Enable earlier interventions for high-risk members while simultaneously improving documentation completeness.
Audit-Proof Your Program
Proactive gap closure minimizes compliance risks and ensures every HCC submission is defensible and data-backed.
Request Additional Information
Start a conversation to expand coding capacity, RAF lift, or prepare for HCC changes.