Navigating the intricate landscape of healthcare poses a myriad of challenges for organizations and at the heart of these complexities lies the daunting task of risk adjustment. The effective management of the risk adjustment process is imperative to ensure health insurance payers have adequate resources to meet the needs of their member population. Risk adjustment requires the management of vendors and the capability to process and supervise the transmission of large amounts of data. Any inefficiencies in this process have immediate financial implications for the organization and its members.
At ProspHire, our team of healthcare professionals offers holistic solutions to bolster every aspect of your risk adjustment program. Whether you require high-level strategic planning, assistance with RFPs, vendor management or program evaluations, we’ll draw upon our extensive knowledge and experience. We excel at pinpointing improvement opportunities that translate into favorable return on investment for your organization.
Solutions at a Glance
See how ProspHire can help address the key issues facing your organization
Client Results
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Encounter Submission Management, Stopping Leaks
Identifying gaps in an encounter submission service contract that totaled nearly $50M in missed revenue -
Unlocking Revenue Potential: A Playbook for Medicaid Contract Optimization
Visibility into state requirements leads to better forecast and revenue projections.
