HEALTHCARE ANALYTICS
Milliman IMPROVE
Medical coding accuracy: It affects your bottom line, and we’ll help you get it right.
Inaccurate medical coding undermines member care and increases financial risk
Medical diagnoses are often incorrectly coded or not coded at all, adversely impacting your members’ healthcare outcomes and increasing your risk of audits, lawsuits, fines, and incorrect payments from risk adjustment programs.
Address errors and reduce risk with our comprehensive statistical model
Milliman IMPROVE analyzes detailed enrollment, medical, and pharmacy data, using a powerful algorithm to zero-in on coding errors and omissions. You get a clear, prioritized assessment of members whose conditions may have been under- or over-coded, along with financial impact estimates. With this information, you can match resources to risks and opportunities and reduce non-compliance with the False Claims Act or risk adjustment data validation (RADV) audit protocols.
Benefits of Milliman IMPROVE
Support multiple needs with one solution
Investigate charts, coordinate care, target wellness campaigns, and integrate with electronic medical records to identify conditions upfront.
Prioritize efforts
Allocate resources effectively with coding errors prioritized according to impact.
Reduce risk
Limit your exposure to RADV audits and government oversight using the REMOVE module to identify potentially unsupported conditions.
Get relevant, timely results
Refresh results as often as you like for real-time performance.
Achieve objective results at an objective price
Enjoy the benefit of transparent results that put you (and not the vendor) in control of your investment.
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