Risk Adjustment
Solutions that cover every last detail.
Nationally recognized for our risk adjustment solutions, Wakely has a comprehensive and in-depth perspective of the most intricate workings of risk adjustment programs. We guide managed care plans and at-risk provider groups towards complete and accurate coding of members, allowing them to maintain operational integrity and optimize financial performance.
Wakely’s unique combination of actuarial, operational, strategic, and clinical expertise has made us a trusted risk adjustment partner for a wide range of healthcare plans and providers.
Wakely’s Risk Adjustment Services
Wakely experts can support plans and providers with a full spectrum of services, including:
- Member and provider level analytics
- Clinical suspecting and insights
- Clinical chart audits, both retrospectively and prospectively
- Full end-to-end retrospective risk adjustment solutions
- Estimation of risk adjustment transfers and accruals for year-end opinions, financial monitoring, and premium rate projections
- Identification of discrepancies in External Data Gathering Environment (EDGE) data and reporting
- Supplemental and chart chase efforts
- Detailed reports identifying gaps and recapture opportunities
- Analysis of financial drivers
- Provider education and engagement
Ready to connect with a Wakely expert?
Request a consultation
