Unlock Missed Opportunities with Retrospective Chart Review
Our Comprehensive Retrospective Chart Review Services to ensure that all clinically documented chronic conditions are accurately captured, validated, and submitted—maximizing revenue and compliance.
Ensure Complete and Compliant Documentation
Healthcare organizations often miss revenue opportunities due to uncaptured chronic conditions, incomplete documentation, or coding inaccuracies. Health Ovations’ Retrospective Chart Review leverages expert clinical validation and advanced analytics to uncover hidden gaps, recover revenue, and align with CMS standards—all while enhancing data integrity and audit readiness.
In today’s value-based care environment, precise retrospective review is essential for accurate risk adjustment, proper reimbursement, and proactive compliance. Our scalable solutions empower health plans and providers to close documentation gaps, improve RAF accuracy, and drive financial performance—without disrupting workflows.
Features
Predict risk score trajectories and HCC opportunities with high accuracy to prioritize interventions.
AI-Driven RAF Forecasting
Identify high-risk members and clinical suspect opportunities by care setting or PCP attribution.
Member-Level Risk Segmentation
Track chart status, coder productivity, and SLA compliance with drill-down to individual providers or clinics.
Real-Time Performance Dashboards
Build and export reports by provider, plan, HCC, or date range—all with Excel, PDF, or API options.
Customizable Reporting Hub
RADV simulations and dual-pass audit tracking minimize denials and prep for CMS reviews.
Audit-Ready Compliance Tools
HIPAA-compliant platform with encrypted data feeds and granular user permissions.
Secure, Role-Based Access
Benefits
Retrospective chart review ensures payers and providers are fairly compensated for the true complexity of their patient populations.
Coding
Our AAPC/AHIMA-certified coders validate clinical notes to capture all documented conditions, improving HCC accuracy.
Auditing
Reduce compliance risks with thorough reviews, a transparent audit trail, and adherence to regulatory standards.
Validation
Ensure documentation accuracy by verifying supported diagnoses and flagging unsupported claims.
Request Additional Information
Start a conversation to expand coding capacity, RAF lift, or prepare for HCC changes.