Health Insurance Enterprise Health Insurance Services Enterprise offers personalized services to help health insurance providers recover, manage, access, organize, and review their members’ medical records. Our HIPAA certified technology has allowed us to simplify processes, optimizing the costs and times associated with document recovery and our related services.
We value all our customers and are committed to providing all necessary registration services. We understand how difficult controls and other registration services are for your business, so let Enterprise take care of them for you. Enterprise offers a complete solution for your audit and record review projects. If you have any questions about our service offerings listed or would like additional information about pricing- please contact us below. Enterprise Document & Data Retrieval

We offer you the industry’s best documentation recovery services that provide you with the fastest and most accurate records possible. Our system includes benefits such as online orders, facility control, on-site scanning, real-time status updates, dedicated customer service, and two quality control cycles. Enterprise HEDIS Record Retrieval

We offer a complete HEDIS solution that helps healthcare plans control the quality of care and service more efficiently. Our system allows multiple cases to be pursued simultaneously, ensuring that all available records are retrieved within the audit timeframe. This helps you save time and money by preventing you from having to collect multiple sets of records for the same patient.
As charts are retrieved, they can be sent directly to you or HEDIS Navigator, and the HEDIS project management tool. Navigator allows charts to follow a workflow in line with the process designed by NCQA. Charts can be assigned to nurses, abstracted, read over, and closed; all without ever having to print a single page.
We have maintained a high level of success in managing the HEDIS audit, as verified by our 97% successful recovery rate over the past five years. We believe it is our duty to work diligently and efficiently to recover any record you need and safely return it to the supplier. Before the start of the HEDIS season, we work with you to establish objectives and benchmarks for the audit’s recovery. You will be regularly updated on these during the project. This transparent communication ensures the satisfaction of our work during the process and the satisfaction of all the needs of HEDIS. We help you solve the problem that HEDIS registration is recovering by managing aspects of the entire project today. Enterprise HEDIS Abstraction

Health plans managed the dataset and information on the effectiveness of health care (HEDIS). We help them evaluate their performance, analyze the quality of the service offered, and the users’ gaps in the performance of the services. Offering these measures provides healthcare plans to improve and increase customer satisfaction.
We provide highly qualified and certified nurses to offer existing staff a complete or integrated solution. Enterprise recruits nationwide to find the best nurses who manage HEDIS projects through our specialized division
The services we provide for HEDIS abstraction are very flexible and can be easily adapted to your wishes. Enterprise can be used as first-line extractors or simply as readers, according to the most suitable needs. When it comes to HEDIS abstraction, be sure to work with the best in the business: Our nurses and HEDIS support staff. Enterprise HCC Record Retrieval

Across the nation, health plans are struggling with the administration of HCC chart reviews. Plans are frequently concerned about controlling project costs, under intense pressure to retrieve 100% of the required charts, and frustrated with poor organization and communication with their current vendors. Between scheduling on-site visits, keeping track of what has been retrieved, and following up with facilities that have not provided the requested records, there is a lot of work for plans to handle.
We are able to achieve a high ROI on HCC recovery thanks to our streamlined and efficient practices and our commitment to identify charts. examines all potential sources of inadequate coding, and once identified, we contact the facilities and work to obtain the records ourselves.
While we have the resources to scan the graphics from suppliers physically, we can also obtain them by fax, mail, or secure uploads containing the project’s total costs. We also provide discounts to health plans when multiple scans of charts are needed from one location to ensure that our interests are aligned.
Another advantage we provide is our willingness to travel to many rural locations that other retrieval services will not. We have found that these locations often have charts with more mistakes, and these charts provide higher ROI for our clients. Whether it’s 4 charts or 40 charts (or more!), and whether the location is large or minuscule, we always give our best efforts to retrieve the records as efficiently as possible and make sure that our clients do not miss out on a single penny. Enterprise HCC Coding

The process of finding and identifying HCC codes inpatient charts is complicated and rarely performed correctly. Without proper documentation and careful coding done by experienced programmers, it is impossible for healthcare plans to acquire their full reimbursements from Medicare Advantage.
We also understand the challenges you face in meeting the various CMS requirements for encoding and sending and offering help by making this process simpler, more efficient, more accurate, and above all, more profitable for you.
Our HCC programmers are highly qualified and highly qualified professionals with years of coding experience. Enterprise has a specialized division of certified programmers that we recruit from across the country via our HCC website. In this way, we guarantee that the code will be documented to your advantage. Our careful recovery and coding processes have allowed us to have a success rate of over 95% for recent healthcare plan projects.
We at Enterprise believe that our programmers are the best in the business. Let us show you. Enterprise ICD-10 Transition

For any healthcare facility to be successful, it is critical that they perform accurate coding. Coding can be a painstaking and challenging task. As of October 1, 2015, all healthcare providers have had to switch from the currently used ICD-9 code set to the new ICD-10 code set. However, this led to a greater probability of error.
The new ICD-10 code set made it possible to ensure that your practice is carefully coded. The ICD-10 code set contains over 55,000 new codes and many updated codes sent to fit the rest of the set better. Training your staff on this new code set will no doubt be expensive and time-consuming.
With the implementation of the ICD-10 code, many healthcare professionals have experienced a loss of revenue and the costs they incurred. No facility can afford to lose revenue in today’s economic climate, we can help you take the necessary steps required to secure that revenue. The best way to ensure that your practice earns all the refund money you are entitled to is to use the programmers’ experience at Enterprise. Enterprise ACO Quality Review

To maintain the highest level of patient care and ensure that operations are performed as efficiently as possible, it is crucial to analyze health plans. We help plans to review and analyze their current processes to identify any service gaps or shortcomings with their existing procedures. The charts are reviewed, and the results are reported as efficiently as possible, making the review process quick and easy for your team. By identifying these shortcomings, we enable health plans to focus their efforts on areas that need improvement.
During our quality review, the charts are reviewed, and the results are reported as efficiently as possible. We designed our procedures to optimize the chart review process so that results can be presented to your team in a matter of days. This allows healthcare plans to quickly collect vital performance information, which facilitates the rapid implementation of effective healthcare solutions.
Our quality reviews are performed in an offsite location to help prevent interruptions in healthcare providers’ workflow. We use the skills of our certified field agents to quickly and quietly steal the critical information we need. Our chart and performance reviews are conducted by agents who receive frequent and in-depth training on a per-project basis. If your health plan is trying to collect significant results, Medical Records’ ACO quality reviews will provide you with what you are looking for. Enterprise RADV/Data Validation

The three-month RADV audit cycle is a rigorous process that requires a lot of work and attention from any healthcare professional.
With the approval of the Affordable Care Act, commercial health plans are now participating in a relatively unknown type of audit known as RADV (Risk Adjustment Data Validation) audit. Almost all health plans are required to perform these audits, and since this is a more recent process, many health plans require not to include what these audits consist of and require. Enterprise has extensive experience in managing audit projects and expertise in managing CMS. Let us manage your RADV project and the following dispute resolution process to ensure that your data is sent accurately and promptly.
The RADV audit consists of a piano collected and transmitted by 200 piano members for each state. Once the CMS provides the list of sample members, health plans are managed by collecting all patient data and medical records that will be needed to validate the risk score for each member.
With our RADV services, we will identify which medical records will provide the best results for each member, and then we will collect this data. Once the critical data was regulated, professional medical documentation programmers thoroughly examined each chart and coded codes to validate the members’ conditions.
Once critical data has been fixed, professional medical documentation programmers examine each diagram and coded codes to validate the conditions of the members.
We work closely with the health plan throughout the process, providing regular updates on our progress and results. Before sending information to the CMS, let’s review our work to verify the accuracy of the data and then provide the results to the piano so we can verify that it has recorded all the information provided.
We manage your RADV project and the following dispute resolution process to ensure that all correct data is assigned promptly, offering your success plan with successful RADV audit requirements. Enterprise Patient Outreach

Go beyond your patient’s care by ensuring that medical records provide comprehensive outreach services for all your precious patients.
Studies have shown that telephone communications and reminders with recently discharged patients limit hospital readmissions and assist healthy patients. The goal of healthcare is to promote better health among all patients, so make patient disclosure a priority today!
Our outreach program tracks patients who are scheduled for treatment and patients who have recently received treatment to ensure that your patients receive the attention they deserve.
Our contact and follow-up service that you consider suitable for your patients. Greater patient involvement leads to healthier and happier patients, so let Enterprise help you get started making a difference today.
Communication is vital for any type of business, and this is especially true in the healthcare sector, where patient experience and outcomes are at stake. With the help of patient awareness services in your medical records, your health plan can guarantee constant contact with your plan members even when your business grows.
With Enterprise patient awareness services, we manage all your communication and awareness efforts, from issuing appointment reminders to surveys and compliance reports, adapting effortlessly to the change in the number of plan members. Our outreach program tracks patients who are scheduled for treatment and patients who have recently received treatment to ensure that your patients receive the attention they deserve. And our service is customizable as we work with you to develop a contact and follow-up program that you consider suitable for your patients.
The goal of healthcare is to promote better health among all patients, so make patient disclosure a priority today! There is no doubt that greater patient involvement leads to healthier and happier patients, so let Enterprise help you get started making a difference today.

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