Prospective Risk Adjustment Services

To supplement records and charts and reveal the whole story of an applicant’s current health status, rely on our Healthy House Calls.  We can help improve data on member health conditions, provide diagnosis of conditions for CMS revenue reimbursement, efficiently establish risk profiles of new members and optimize the viability of your plan.

EMSI offers comprehensive, end-to-end programs for prospective risk evaluation. We begin with Healthy House Calls, conveniently scheduled online or through our service center. Our mobile medical providers gather complete health information and provide a complete report of all conditions, existing or previously unidentified.

We can also integrate Hierarchical Condition Category (HCC) coding into our process, capturing any current or previously undiagnosed conditions.

All information gathered in our Healthy House Calls adheres to CMS guidelines and supports your Risk Adjustment Processing System (RAPS) management process.