Health Insurance

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At Enterprise, we redefine the landscape of health insurance services. Our mission is to empower health insurance providers with unparalleled efficiency in retrieving, managing, and analyzing their members’ medical records. Utilizing our HIPAA-certified technology, we’ve engineered a solution that streamlines document recovery, dramatically reducing costs and time without compromising quality.

Our Commitment: Your Ease and Efficiency

We recognize the complexities of registration and document control in your sector. This is why Enterprise is dedicated to assuming these challenges, allowing you to focus on your core business functions. Our comprehensive suite of services ensures a seamless solution for your audit and record review needs.

Document & Data Retrieval: The Pinnacle of Precision

Our industry-leading documentation recovery services deliver speed and accuracy like no other. We offer a spectrum of benefits, including:

  • Online ordering and real-time status updates.
  • On-site scanning and facility control.
  • Unmatched customer support, complemented by two rigorous quality control cycles.

HEDIS Record Retrieval: Efficiency Redefined

Our complete HEDIS solution optimizes the quality control of healthcare plans. Our system is designed for simultaneous case handling, ensuring timely retrieval of all necessary records. This not only conserves time and resources but also eliminates redundant record collections. Our 97% success rate over five years stands testament to our commitment to excellence.

HEDIS Abstraction: Expertise at Your Service

Our HEDIS abstraction services are flexible, adaptable, and led by highly qualified, certified nurses. We recruit nationally, guaranteeing you the best talent for managing HEDIS projects through Whether as primary extractors or reviewers, our services align perfectly with your needs.

HCC Record Retrieval: Surpassing Challenges

Navigating the complexities of HCC chart reviews is our forte. Our effective practices ensure high ROI, focusing on identifying and retrieving the most critical charts, even from remote locations. Our goal is aligned with yours: maximizing recovery and minimizing missed opportunities.

HCC Coding: Precision and Expertise

Our certified coders, recruited through HCC, bring their extensive experience to ensure accurate, advantageous documentation for your healthcare plans. Our meticulous approach has yielded a success rate of over 95% in recent projects.

ICD-10 Transition: Seamless and Accurate

We facilitate a smooth transition to ICD-10 coding, ensuring accuracy and minimizing revenue loss. Our experienced programmers are equipped to guide your practice through this critical shift, safeguarding your financial interests.

ACO Quality Review: Excellence in Patient Care

Our ACO quality review process is swift, efficient, and focused on identifying areas for improvement. Conducted offsite to avoid workflow disruption, our certified field agents ensure the highest standards in chart and performance reviews.

RADV/Data Validation: Comprehensive and Accurate

We excel in managing RADV audits, ensuring data accuracy and timely submission. Our process is thorough, from identifying the most impactful medical records to detailed examination and coding.

Patient Outreach: Enhancing Patient Engagement

Elevate patient care with our comprehensive outreach services. From appointment reminders to follow-up surveys, our program is designed to increase patient engagement, contributing to better health outcomes.

At Enterprise, we’re not just a service provider; we’re your partner in redefining healthcare efficiency. Let us demonstrate our commitment to excellence.

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