Risk Adjustment software solutions

Healthcare Risk Management Software Solutions

Business Challenges

OSP Labs healthcare risk management software solutions offer users powerful insights to assess the potential liabilities and eliminates the need for sourcing services and technology from multiple vendors. Our healthcare risk adjustment services have become increasingly relevant as latest health reforms have redefined the way health plans should conduct business. Our risk adjustment solutions provide an integrated set of tools that offer suspect targeting, data validation, encounter data submission, risk trending, suspect analytics and more. OSP Labs’  medical risk adjustment & reimbursement solutions offer financial acumen by identifying and prioritizing claims by the liabilities involved and positively impacting the revenue. Our solutions help to reconcile discrepancies, and to bring balance to the demands of payers and government.

Solution Design and Development

OSP Labs offers fully integrated healthcare analytics and healthcare risk adjustment software solutions to help our partners identify and assess the liabilities beforehand, proactively improve revenue and the quality of healthcare.

  • OSP Labs' healthcare risk management software solutions follow a fully integrated and data-driven approach by combining retrospective and prospective liability adjustment programs. The integrated risk adjustment help closing gaps in targeted and efficient manner and yield higher accuracy to liability data score.
  • OSP Labs' Medical Risk Adjustment software solutions include liability Analytics to identify gaps in risk adjustment factor (RAF) score and prioritize resources accordingly. Risk analytics facilitates analysis of liabilities based on alternate data sources, such as care and pharmacy management data, to identify all possible risk gaps.
  • OSP Labs' Medical risk adjustment & reimbursement solutions offer instant and user-friendly access to all risk adjusting data including medical claims, coding results, liability assessment data, provider diagnosis distribution and more.
Values Delivered
healthcare fraud detection software solutions | fraud management solutions
Risk Score Trending
Easily find, decipher and monitor residual risk score trends and related metrics like average risk scores, expected risk scores and more.
healthcare risk management software solutions
Risk Targeting
Risk targeting is a portfolio allocation strategy that tries to have the same portfolio volatility in every market environment.
healthcare risk adjustment software solutions
Flexible Reporting
Self-generate custom liability analytics and access flexible risk reports, score summary, payer and provider targeting, diagnosis history, and payment summaries.
medical risk adjustment software solutions
Supplemental Submission Analytics
Gain access to analytics support for decision-making and file creation for RAPS submission and EDPS coding project submission.
medical risk management software solutions
Suspect Analytics
Identify members with possibly undocumented suspect conditions that are appropriate for prospective and retrospective targeting.

What Makes OSP Labs’ Risk Adjustment Solutions Best for Your Need?

OSP Labs healthcare risk management offers seamless integration of all the essential solutions in the gamut of liability management. We deliver standalone risk adjustment solutions that drive strategic growth by providing the ability to anticipate, assess and minimize potential risks.

Identify risk adjustment factor score gaps and prioritize healthcare resources used for liability adjustment activities.
Gain access to advanced risk analytics tools that offer comprehensive risk assessment and management capabilities.
Assess potential risks and counter the liability gaps from the system to manage cost reductions and patient payment challenges effectively.
Ensure compliance with myriad health regulations across multiple geographies within cost and time restrictions.
Create a single, in-depth and integrated view of liabilities and compliance across the organization.
Link assessed risks to causes, events, dangers and other elements of governance, risk, and compliance.
Implement the customized risk adjustment parameters and navigate through the risk analytics metrics to monitor the potential liabilities.
Identify the undocumented HCCs within targeted medical records using powerful, intuitive and configurable risk adjustment analytics solutions.

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See how our solutions can help resolve your healthcare challenges.

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