Surviving today’s environment as an insurer feels a bit like trying to escape from a pressure cooker. Between regulatory uncertainty, increasing amounts of patient data, industry consolidation, and an aging population, health plans are being pulled to the breaking point by numerous factors.
Healthy Fidelity’s NLP-enabled risk adjustment solution offers insurers a complete and holistic view cutting across all risk adjustment activities to usher in the next generation of risk determination. Break free from the operational constraints to better project, detect, and capture the true risk of your membership across all lines of business.
How to Get There
With Health Fidelity, complete and accurate risk capture is attainable with our modular application suite, customizable to your specific needs and readiness:

Data Acquisition
Lower the cost and hassle of chart retrieval and medical records management and supply the NLP with the broadest set of documentation available via Lumanent Connect.

Clinical Suspecting
Improve risk score accuracy and enable providers to close diagnosis gaps on suspected conditions with Lumanent Suspects.

Retrospective
With Lumanent Retrospective Review, improve the productivity and efficiency of your internal coding staff to manage first or second pass reviews.
Consolidated Client Outcomes
4X
Increase in Coder Productivity
20-30%
Increase in Risk Capture
40%
Decrease in Costs

Partner Spotlight: UPMC
In 2014, UPMC Health Plan, as part of a leadership-sponsored strategic initiative, implemented Lumanent Retrospective Review to help increase accurate RAF capture in compliance with CMS Risk Adjustment guidelines while improving overall coding efficiency.
The health plan, which was already running sophisticated risk adjustment operations, saw a remarkable return on investment with a study conducted on PY2012 members.
“Lumanent Retrospective Review completely transforms the process of risk adjustment through its intuitive workflow. By consolidating all essential data points into one managed workflow, we can ensure efficiency, compliance, and accurate and optimal risk capture, affording us the opportunity to spend more time focusing on the quality of care provided to our membership.”
– Mary Beth Jenkins, SVP & COO, UPMC Health Plan