MEDICAL RECORDS AUDITS & REVIEWS
Risk Adjustment and Quality (HEDIS) Program Support
The right record, on time, every time.
Sharecare’s strategic network of relationships with the largest health plans and requestors ensures compliance and timely submission of records supporting risk adjustment and quality programs.
Through our managed relationships with requesting entities, we can reduce the administrative burden on your staff generated by retrieving medical records.This allows your practice to focus on top-notch patient care. In addition to reducing abrasion, Sharecare maintains industry-leading fulfillment rates, ultimately boosting CMS program success.
Audits we support:
- MRA – Medicare Risk
- CRA/ACA – Commercial/IFP, Affordable Care Act
- HEDIS – Health Effectiveness Data and Information Set
- RAD-V – Risk Adjustment Data Validation
- DRG/PI – Diagnosis Related Group
- And more
Partnerships
Sharecare’s close partnership with the requestors allows a streamlined fulfillment of medical records requests supporting risk adjustment and quality use cases.
Services we provide:
- Chart release for in-network Sharecare locations
- Chart acquisition for out of network providers
- HCC coding services
- 1LR/2LR
Value to the provider:
- Ensured government program compliance
- Reduced abrasions
- Re-allocation of resources
Value to the health plan/requestor:
- SHCR roster matching and pre-matching
- Standardized account management support/meetings
- Production planning
- Status visibility
- Electronic delivery
Why is timely risk adjustment participation important?
It enables fair compensation based on your patient population’s health risk. A provider serving high-risk patients may be penalized if he or she fails to participate in risk adjustment when an adjustment in payments would reflect the level of care required.
Identifying risk factors helps providers better understand their patients’ needs and improve the quality of care.
By the numbers
3.1M+
charts delivered annually
225
different health plans served by Sharecare in 2023