ReconEdge™
Health Risk Partners helps you meet the highest levels of compliance and profitability through operations consulting and use of ReconEdge™, our secure web-based financial reconciliation system. Utilizing this robust and secure tool, we can assess your organization's opportunities, and recommend strategies for reaching your performance objectives.
Overview
- Identifies enrollment discrepancies promoting timely resolution between the plan system and CMS related to enrollment and demographic information
- Validates CMS risk scores and premium calculations
- Calculates receivables and other financial reconciliations related to Part D
- Provides member-level and diagnoses reports for payment and HCC auditing
- Offers management level reports for monitoring of plan performance
- Promotes revenue maximization using a proprietary database of over 5,000 mapped and weighted diagnoses codes and 9,000 NCD codes to map health conditions and identify coding errors
The IT Advantage
ReconEdge™ is the perfect combination of intellectual know-how and technology. We have taken the best business practices in the industry and powered them with robust technology to deliver our clients tools that help them surpass their competition. We respond to the new CMS data and modifications in CMS data formatting so our clients don't have to.
As an ASP model, we are able to make updates, additions, and improvements to our system on a frequent basis. Our servers hold all of the data to do all of the heavy lifting. The servers are located in a SAS 70 type 2 certified facility, to ensure the highest standards of security and compliance.
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