Health Plan Services
Enabling Health Plans manage medical costs, optimize payments and measure quality of care through clinical solutions for superior outcomes.
VRCM is a leading provider of Risk Adjustment services, Health Plan Services and Health Plan Solutions for Healthcare Payers including Insurers, Health Plan Providers, Brokers and Administrators. We deliver value-added services in Retrospective / Prospective Chart Review, Chart Audit, HEDIS Abstraction and RADV Audit that enable healthcare payers to significantly improve revenue, reduce error rate, cut cost and improve quality objectives.
Services
Chart Review
VRCM enables health plans to maximize their risk-adjusted revenues and improve risk score accuracy by accurately identifying coding and documentation gaps and facilitating…
Quality Measure Reporting
Our team of Nurse Practitioners and Coders abstract and accurately report on all HEDIS measures (as per NCQA technical specifications) related to Health Plan’s…
Payment Accuracy
Clients can leverage VRCM’s Certified Nurse Practitioners and coding resources in undertaking chart audits for Hospitals , DRG & DRG short stay audits & APC validation…
Markets We Serve
With VRCM, you’re assured of the highest quality and most cost effective services from highly skilled coders.
Client Benefits
Retrospective Chart Review and Audit -
Ensuring accurate, compliant coding practices
Minimize Errors & Maximize Accuracy -
Cut down errors and improve precision in Raps Submission
Detailed Drill Down -
Deeper insights into specificity of patient diagnosis through subject matter expertise
Trained & Certified Coders -
Best coding staff certified in AAPC
Assured CMS Compliance -
Ensure effective CMS compliance in terms of codes
Validation of Identified Opportunities -
Validating all coding gaps in the compliant manner
