Irvine, Calif. (PRWEB) March 9, 2006
Dynamic Healthcare Systems, a provider of innovative solutions for Medicare Advantage health plans, today announced the expansion of its Voyager software suite with the launch of an advanced HCC Analytics module, designed to maximize revenue to Medicare Advantage Plans and Medical Service Organizations (MSOs) under the risk adjustment reimbursement model. Concurrently, Dynamic is launching a comprehensive RAPS Data Management Module designed to efficiently submit, reconcile and manage risk adjustment data exchanged between Medicare Advantage health plans and CMS.
The HCC Analytics module identifies missing and mis-coded ICD9 codes that have not been reported in qualified encounter data through the use of crosswalks and proprietary algorithms. Each suspected missing or mis-coded ICD9 code is identified by the likelihood that the suspect will result in an actual new or corrected ICD9 code, increasing the program effectiveness and the return on investment.
“Our goal is to provide comprehensive solutions that allow Medicare-focused businesses maximize their revenue cycles and scale their membership with out adding additional staff, “ said Ken Stockman, founder and CEO of Dynamic Healthcare Systems, Inc. “New revenue models created by the Centers for Medicare and Medicaid Services are based on the health status of Medicare members, which is determined by the severity of specific conditions and compensates plans at a higher rate for sicker members. Our solutions are available as a licensed software, hosted application or fully-managed service. It automates the management of data and provides advanced analytics, allowing health plans to identify, document, track and report missing or miscoded ICD9 codes that represent significant dollars currently unrealized by plans and MSOs. 2007 will be a hallmark year for changes to Medicare Advantage (MA) reimbursements. Both the move to 100% compensation using the HCC model and the start of the Budget Neutrality Factor phase out, place significant pressure on MA plans to increase and maintain the highest possible risk scores.”
Dynamic’s HCC Analytics module applies proprietary algorithms to qualified encounter data and unqualified secondary sources like, lab results, DME, and prescription encounters, to uncover suspected gaps in ICD9 code reporting. Plans and MSOs use Dynamic’s work queues, detailed patient profiles and sophisticated report libraries to verify the suspects in medical records, document the actual outcomes and submit them to CMS.
Dynamic Healthcare Systems, Inc. will be exhibiting at Booth #8 during the California Physicians Group (CAPG) Conference on March 10, 2006. Our specialists will be available to provide toolkits and expertise on building effective risk adjustment programs
About Dynamic Healthcare Systems
Dynamic Healthcare Systems, Inc. provides comprehensive technology solutions for health plans and MSOs striving to succeed amid new and evolving regulatory requirements. Headquartered in Irvine, California, the company brings world-class innovations to middle market companies serving the Medicare population. Dynamic Healthcare Systems can be reached at (949) 975-1877. http://www.dynamichealthsys.com.