IKS Health Services

IKS Risk Coding Solutions – Medical Coding
As It Should Be

Healthcare provider enterprises are in varying stages in their journey from volume to value and the move to value based care is rapid and inevitable. The ability to document care, capture risk and coding accurately is a key to success with both financial and clinical implications

IKS’ clinical coding solutions enable provider enterprises to succeed in the world of value across the spectrum of risk. Our coding solutions account for the full clinical context of the patient with our rich clinical expertise and experience. Ours is an integrated solution for ensuring accurate risk capture so you can get the full picture of the patient’s health. Supported by a robust bi-directional query process with physicians, we optimize documentation and coding. IKS Health can grow seamlessly as you grow, eliminating the need to hire, train and maintain coding staff. Efficiency and accuracy are guaranteed through our proven HCC Coding solutions.

How It Works

To determine & prioritize the scope of patients to be reviewed for optimizing RAF

– Review of Patient Records (including outpatient visits, inpatient discharge summaries, pharmacy & claims data) for last 12 months to accurately identify and capture risk

– Identify Missed HCC / insufficient documentation / Possible HCC opportunities

To determine additional HCC captured, RAF Score, HCC Recapture Rate & Encounter Reconciliation

– Sample audits for specific member cohorts to identify documentation / coding issues

– Enable preparedness for CMS and other payer audit