Indegene CodeMax – Coding Solution

CodeMax is Indegene's proprietary EMR-integrated Risk Adjustment solution with an end-to-end process workflow management. It provides near real-time view of the Risk Adjustment process supporting managers and coders in taking data-driven decisions to drive financial and operational outcomes.

Improve Risk Adjustment Outcomes by Tapping Into EMR Data

Benefit from our proprietary risk adjustment models (EMR+™) running against encounter and EMR data to arrive at high accuracy HCC documentation.

Increase Speed and Accuracy of HCC Coding

Use our highly customizable workflows with proprietary inbuilt intelligence that helps coders by providing assistance such as suggested codes, suspect patterns and robust condition, and medical terminology search in your data.

Leverage Action-Driven Workflows

Drive effective collaborative action on the coding and review process utilizing our work planning, execution, and monitoring workflows (Indegene CodeMax), which can be tailored to support your organization.

EMR-driven risk adjustment

Leverage the EMR and paper-based medical records data present in your network to get a true picture of your population risk. An end-to-end Risk Adjustment platform with Intelligent Assist, which allows you to plan and coordinate Risk Score Calculation, Suspect HCC Identification, Medical Record Retrieval, Supplemental Diagnosis Coding, and CMS Data Submissions.


Features

Integrated Insights from both Structured and Unstructured Data

Utilize data from multiple sources and silos like administrative records, EMR, patient chart scans, labs, prescriptions, etc, in an integrated fashion to drive your Risk Adjustment and Coding process. Use same workflows for coding both EMR and scanned medical charts.

Proprietary Intelligence to Uncover Uncoded/Undercoded Records

Easy-to-use tools that help flag and extract EMR records suspected to have uncoded/undercoded opportunities that can be reviewed by coders for finalization.

Accurate Information to Coders on Clinical Markers and Diagnosis Embedded in EMR

Context sensitive extraction of clinical markers and diagnosis information, which helps coders review EMR records in a much more efficient and effective fashion. Advanced algorithms to review and predict probable/suspect ICD9/ICD10 codes.

Improved Quality Measurement Accuracy

When deployed along with our HEDISPro™ solution, the presence of data from EMRs ensures that the quality measure calculations are more accurate and reflect the true compliance levels for the population. The platform is also future ready with the ability to compute HEDIS scores based on data from electronic clinical data systems as defined by NCQA.

Built-in Support for Audit and Reporting

We provide a flexible Audit suite that ensures that the Risk Adjustment source records are available for Audits both internally and externally. Reporting capabilities cover both business impact and operational needs.

Benefits

Integrating Advanced Clinical Analytics and EMR Mining

Highly scalable, fast, and efficient platform that supports end-to-end risk adjustment integrating EMR and paper-based records.

High Accuracy in Identifying Coding Opportunities

Proprietary clinical algorithms and models ensure that coding opportunities are identified and leveraged properly.

EMR Record Selection based on Coding Guidelines

Most relevant EMR records, having gaps that are clinically accurate and compliant with coding guidelines.

Intuitive and EASY-TO-USE Coding Interface with Intelligent Assist

Make coding simpler through features like highlighted relevant clinical markers and sections, code suggestions, visual code deletion, etc.

Simplified Hybrid Record Review

Same workflows for handling both scanned charts and EMR charts ensure that the hybrid record review process can be carried out more efficiently as data from all sources can be reviewed from a single interface.

Control and Monitor through Pre-configured Workflows

Different user role-based access to data and actions, which include ability to define, segment, allocate, code, review, and audit the coding and clinical analytics performed on the platform.

Resources


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