EMR-integrated module reviews nearly all sources of patient data to identify potentially risk-adjustable conditions for clinical review before the encounter.
Lumanent® Pre-Encounter Prep is a Natural Language Processing (NLP) powered prospective risk-adjustment solution for provider practices. The product extends Health Fidelity’s leadership in delivering risk adjustment capabilities to its partners. Pre-Encounter Prep uses Lumanent Insights, Health Fidelity’s industry-leading NLP engine, to interpret unstructured clinical data, providing suspected but unconfirmed conditions to care teams for review ahead of a patient encounter. With its ability to derive insights from both past claims data and clinical records, Pre-Encounter Prep gives providers the ability to surface, evaluate, and close risk gaps (missed risk adjustable diagnoses, or those in need of annual reconfirmation) prior to initial claims submission. In doing so, providers are aided in more directly targeting and addressing chronic conditions while supporting fuller, more accurate value-based care reimbursements.
Lumanent Pre-Encounter Prep’s integration and addition to the Epic App Orchard allows Lumanent to deliver NLP derived clinical suspects to be reviewed in the HCC BPA module. Lumanent Pre-Encounter Prep also has the ability to filter back any suspects that would already be triggered or known by the HCC BPA to remove redundancy in suspects surfaced for provider review. Based on the impact of Lumanent Suspects, the prospective technology behind Pre-Encounter Prep, Health Fidelity expects an average RAF lift of up to 5% across partners.
Health Fidelity CEO Steve Whitehurst notes, “Lumanent Pre-Encounter Prep is purposely built to help providers succeed under value-based care arrangements, compounding the financial and clinical impact of risk adjustment within existing workflows. It integrates risk adjustment into the care setting via EMR interoperability with Epic and improves the accuracy of submissions.” He continued, “By providing the tools for clinical staff to efficiently review and vet suspected conditions, it ensures physicians only see high-confidence prompts at the point of care, delivered via familiar, standard Epic functionality. This application helps providers to improve at-risk performance without interfering with care delivery.”
Health Fidelity’s Pre-Encounter Prep solution is a part of the larger Lumanent suite of risk adjustment tools, including Post-Encounter Review for providers and Retrospective Review for payers.
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