A successful prospective risk evaluation requires comprehensive and detailed information about a member’s current health status. As the industry leader in medical record retrieval services, EMSI Health offers comprehensive, end-to-end programs for prospective risk evaluation. Our services 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.
Our Healthy House Calls® supplement medical charts and reveal additional information about a member’s current health status. Conveniently scheduled online or through our service center, Healthy House Calls allow our mobile medical providers to gather complete health information and provide a comprehensive 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.
Member Self Scheduling
Because today’s health plan members are more active than ever before, it can be difficult to reach them at home via telephone. With our first-to-market member self-scheduling tool, members can schedule their Healthy House Call at a time that is convenient for them. In addition to making it easy for members to schedule their Healthy House call, the Self Scheduling tool also speeds up the appointment scheduling process and increases the total number of appointments scheduled.
How It Works
Members (or caregivers) can enter their zip code and select a preferred date and time for the appointment. Once the appointment request is routed to our call center, a customer service representative matches a provider with the member’s requested appointment time and confirms the appointment with the member.
Healthy House Calls for Medicare Advantage Plan members
In-home visits provide the most complete picture of a member’s health status. EMSI Health offers Healthy House Calls for Five Star Quality Ratings and prospective risk adjustment initiatives.
Healthy House Calls from EMSI ensure the strength of your Medicare Advantage Plan by evaluating existing members’ current health status and helping you establish prospective risk profiles for new members.
In addition to providing you with a reliable report on a member’s health, Healthy House Calls offer many benefits to your members, including:
- A detailed, current health summary
- Early detection of previously unknown ailments
- A relaxed setting to discuss health issues or questions
- Coordinated physician care (we send a copy of the evaluation to a member’s private physician)
- Increased plan satisfaction
How It Works
A Healthy House Call is quick and convenient. Our trained information specialists contact members, schedule in-home visits and complete any customized forms you may require. Our licensed medical providers then conduct a thorough, respectful health evaluation and any requested preventive screenings in a member’s home. Healthy House Calls can help your members manage their health while ensuring the strength of your Medicare Advantage plan.
Contact us to start scheduling Healthy House Calls.
Healthy House Calls In-Home Assessments for Commercial Health Plans
With a tradition of excellence built over more than 40 years, EMSI Health is the leading provider of risk adjustment services, as well as the largest in the industry. Our robust operational framework, experienced staff and proven performance over more than four decades have positioned us to successfully leverage our scalable capacity, provider relationships and technology to deliver complete medical data quickly and efficiently. Our mission to drive improved outcomes for our clients through the delivery of powerful information guides every transaction and interaction conducted, each and every day.
How It Works
EMSI Health's convenient, professional in-home Healthy House Calls are performed in the member’s home by our licensed, trained medical providers. The providers capture applicable information and health conditions, encouraging members to seek any additional care through their primary care physician.
We also offer services that provide the member with your customizable, educational materials related to their health conditions or in your care management programs. Our experienced scheduling center is fully equipped with the technology and staff required to coordinate member contact, scheduling of the Healthy House Call, as well as customization capabilities for completion of forms.
Healthy House Calls can be electronically completed using our eEvaluation iPad application. This tablet technology speeds up submissions of completed evaluation results compared to paper forms, decreasing errors and improving administrative control of data. You can also choose to have medical history, current prescriptions and primary care physician information securely preloaded into the electronic evaluation form prior to the Healthy House Call.
Learn more about what we can do to help you prepare for and succeed in the Health Insurance Marketplace. Contact us today.