Risk Adjustment Solutions

Full-service revenue cycle and patient contact center solutions focused on maximizing operating margin.

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Our certified coders submit claims mapped to over 70 HCC codes in the RA model

Risk Adjustment in Healthcare

As risk adjustment models continue to expand, Global Healthcare Resource provides the expertise needed to manage increasing complexity. Our HCC trained medical coders deliver accurate, timely coding aligned with current payment methodologies and the highest levels of diagnostic specificity. Supported by deep specialty expertise across hospital, post acute, radiology, nephrology, and other care settings, Global ensures risk adjustment programs are executed with precision and confidence.

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Every Missed Code is a Potential Care Gap

We excel at optimizing risk adjustment scores by lowering cost and improving quality of care. Our trained and certified coders submit claims that are mapped to over 70 HCC codes in the RA model. Our coders and nurses work together, being proactive to engage patients who have care gaps to schedule appointments. Our specialists take initiative in reviewing records to capture missing diagnosis and record a thorough HCC code review. 

 What We Can Offer: 

  • Retrospective services 
  • Concurrent Chart Review 
  • Data submissions 
  • RADV, HEDIS, or Medicare Advantage audit support 
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