Coding InSight for Payers

Advanced NLP-enabled Risk Adjustment Solution for Medicare Advantage, ACA Commercial and Medicare ACO Markets

Automated Risk Adjustment Coding for Improved Efficiency and Productivity

The Coding InSight workflow application combines our proprietary, purpose built NLP, machine learning and an extensive health taxonomy to streamline the manually intensive retrospective chart review process. Coding Insight quickly uncovers missed codes and documentation gaps in member data so coders can process higher chart volumes with increased accuracy and efficiency, for improved plan revenues, higher audit confidence and reduced administrative costs.

Gain more control of your risk adjustment processes. Increase efficiency. Lower costs. Improve revenue.

2X-3X

Coder Productivity Increase

26X

ROI
Increase

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Robust Features Transform Your Coding Workflow into a Powerful Tool for Risk Adjustment Success

Unified Coder Workspace

Coders view all relevant clinical and financial member data in a single intuitive, yet powerful workspace to quickly and accurately reconcile codes

Automated Suspect Identification

Coding InSight is fully automated so coders can identify missed codes and documentation gaps faster and with a higher level of accuracy. We take away the need to manually comb through large volumes of clinical data, which is both time-consuming and
error-prone.

Analytics and Reporting

Coding InSight’s comprehensive suite of dashboards delivers real time, actionable data that enables administrators to track coder productivity and financial impact from risk adjustment. Coding InSight also tracks provider coding patterns for improved provider engagement and CDI initiatives.

Multi-Factor Auditing Capabilities

Coding InSight streamlines the reconciliation process by making code recommendations based on evidence found within the member data. Coders gain a clear line of sight between claimed codes and supporting documentation in case of an audit.

Talix Platform

The Core Technology that Powers Talix

We built the Talix platform with one goal in mind: to provide powerful, high quality, analytics-driven solutions that enable risk-bearing organizations to gain greater insights and succeed in the age of value based care

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SaaS Application Framework
(Cohort Designer, Reporting/ Analytics Framework, Administrative Interfaces, Data Connectors, OCR)

Clinical Taxonomy

NLP

Clinical Rules

Machine Learning
“Accurate and complete diagnostic coding provides a comprehensive disease burden profile of our members. As our member population grows, we needed an advanced diagnosis coding solution to help improve our productivity so we can support increasing workloads while still maintaining our high quality standards. Coding InSight helps us identify un-coded or mis-coded opportunities in a more effective and efficient way.”
 Karena Weikel, ASA, Vice President of Risk and Revenue Management, Geisinger Health Plan
Creativity redefined. These guys offer a unique approach to every aspect
of design and the result is simply stunning.
JANE LARKIN - MUD CLOTHING.
Creativity redefined. These guys offer a unique approach to every aspect
of design and the result is simply stunning.
JANE LARKIN - MUD CLOTHING.

Downloadable Documents

Coding InSight Overview Brochure for Payers

Winning in Risk Adjustment

In Development

Claims InSight for Payers

Validate submitted codes, reduce coding errors and close documentation gaps for increased RADV audit confidence.

Quality InSight

Identify care gaps and track performance for improved quality reporting under HEDIS, STARS and ACO benchmark measurements.

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Coding InSight for Providers

Streamline Risk Adjustment Coding for Improved Accuracy and Better Care Planning

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