health plans
At TMI we are working closely with many health plans in all 50 states, Puerto Rico, and the District of Columbia to achieve a meaningful impact in today’s healthcare. At the core of our effort is a focus on medical informatics, improving its accuracy, improving its insight and improving its impact. With our industry expertise and unique approach, we provide unmatched solutions that are meaningfully improving clinical and quality outcomes, disease management, and the financial efficiencies.
- Risk Adjustment:
Medicare Advantage plans rely on proactive Risk Adjustment to reflect accurate risk scores in order to realize correct reimbursement levels. These risk scores reflect acuity levels of patients via the Hierarchical Condition Category (HCC) system. The HCC system is an additive system which relies on ICD-9-CM diagnosis codes to reflect patient acuities at their greatest specificity. TMI offers a combination of solutions to help achieve this goal.
- HEDIS:
We can help in your company’s effort to meet the stringent *NCQA HEDIS measures. Once you’ve selected the charts you want reviewed we can schedule with the provider’s office, scan the records, and securely provide them in your choice of digital format.
