Blog Resources Careers Contact Us Records Request About Us Technology Patients Commercial & Govt Providers Health Plans Life Sciences Risk Adjustment Solutions You are here: Home / Health Plans / Risk Adjustment Solutions Comprehensive Approach Retrospective Solutions Prospective Solutions Risk Adjustment Solutions for Health Plans Position your health plan for risk adjustment success Meet the challenges of risk adjustment with a highly effective comprehensive Risk Adjustment solution. With Ciox you have one single vendor to help you manage your risk adjustment process right up to submission. Ciox offers the right tools to improve business intelligence, capture implied yet unaccounted for conditions, pursue medical records with the highest probability of yielding additional reimbursement, and express the true burden of your member population. Our flexible and modular approach brings your risk adjustment projects into one location, with analytics and results in dashboards that look and feel familiar. Learn More Risk Adjustment Solutions Request a Call Comprehensive Approach to Risk Adjustment As a health plan decision maker, you want to know if the health conditions reported in the medical records you receive are accurate, current, and complete. With Ciox as your partner, you achieve: Good member/provider connections Efficient medical record retrieval High quality analytics with member-, provider-, and campaign-level drill-downs Our Risk Adjustment Solution and Services support the needs of: ACA Medicare Advantage Medicaid CMS Direct Contracting Our full-service Risk Adjustment Analytics system provides: Chart Retrieval & Data Acquisition – Digital & Traditional Risk Adjustment Coding – HCC Coding and Abstraction Second Level Review – NLP Powered with Machine Learning Data Abstraction – Structured & Unstructured Analytics – Pre & Post chase with intuitive reporting Data warehousing Risk score calculation Member targeting Provider selection Retrospective Risk Adjustment Solutions The information you need, when you need it, to validate data and close gaps The most effective retrospective risk adjustment requires a complete understanding of your members and their qualifying health conditions. Ciox not only expedites access to the clinical data you need through our expansive medical records retrieval network,we deliver both the proprietary technology to assess your data’s accuracy and the coding power to make adjustments, as necessary. Reflect Each Member’s True Health Conditions for Proper Compensation Ciox gives health plans the services and support you need for retrospective risk adjustment success: The right data: Using Ciox’s medical record retrieval services, you start the risk adjustment process with the most comprehensive member data available. Digital First approach to retrieval insures faster access to the clinical data you need. The right technology: Our proprietary algorithms and datasets identify members with the greatest probability of having undocumented health conditions and missing diagnoses, so you benefit from access to the greatest number of charts and a complete understanding of your members and their qualifying conditions. Suspect analytics: We can predict the value of coding each of your member subsets to determine probable ROI. Complimentary Outreach: Our outreach solution focuses on identifying the right provider contact to retrieve the records and is offered complimentary with our retrieval project. HCC Coding: Ciox will partner with you and can provide high-quality coding and audit services by CCS-certified experts on or offshore. Prospective Risk Adjustment Solutions Improve health and financial outcomes with minimum provider abrasion Ciox has the AI powered prospective risk adjustment solution you need to drive meaningful provider interactions, confirm pre-existing conditions, enhance HCC coding, and promote improved and appropriate health care for your members. Provider Relationships Drive Positive Outcomes Good provider relationships translate to accurate and thorough documentation. Accurate documentation translates to optimum risk adjustment payments. Ciox maintains insights about 75,000 provider locations, their past records, likelihood to respond, and response timeliness. Using our proprietary algorithms and datasets, ongoing analysis of intervention data, and these provider insights, you have all the information you need to: Identify your high risk members. Confirm which members — or member subsets — may have undocumented health conditions and need reassessment. Select providers for outreach. Realize the optimal record retrieval method. Confirm existing health conditions. Improve documentation with minimum provider abrasion. Ensure high risk members are seen often enough and getting the care and follow-up they need. Reduce future gaps in care. Advanced Technology Minimizes Administrative Burden When you work with Ciox, you get analytics and results in dashboards that bring every risk adjustment project into one location. These dashboards are interactive and customizable to assist with data manipulation and analysis. And they are intuitive, easy-to-use and look and feel like a familiar toolset. Quickly identify conditions not previously identified through claims data to create a suspect list to target within your prospective risk adjustment program. Quality Medical Record Retrieval HEDIS, RAD-V & STARS, Digital and Traditionally retrieved medical charts & abstraction Digital Connectivity Ciox Digital Direct™ identifies electronically available member encounters for health plans, improving access and outcomes, saving time and resources, and expediting fulfillment without provider abrasion. Business Intelligence/Analytics Pre & Post Chase Member analysis and insight HCC Coding On & Offshore Hierarchal Condition Category Coding Services Second Level Review Coding Cross Check – NLP & Machine Learning powered 2LR Coding service Contact Ciox to Learn How to Improve Your Risk Adjustment Process Contact Us eVerify Federal ID #116278 March 27, 2014 Contact Ciox Quick Links Join Our Team Ciox in the Press Client Login Privacy Policy From Our Blog Health Catalyst Partners with Datavant to Expand Access to Clinical Trials as a Care Option for Patients With Privacy Hub, Datavant Strengthens Protections for Patient Privacy in Health Data Exchange No-Cost Quality Improvements: Strategies from Ciox Health Follow Us © Copyright 2021 - Ciox