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Prospective Gap Identification

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Prospective Gap Identification

Turning Your Existing Data into Actionable Intelligence

Our Prospective Gap Identification platform leverages your existing data to identify gaps in member’s risk scores, enabling you to better direct your efforts.

Improve Risk Score Accuracy

Use the power of your data to improve risk score accuracy and provide clinical insights with Advantasure’s Prospective Gap Identification platform. Our proprietary algorithms leverage your existing data to identify gaps in documentation and care by targeting historical and suspect medical conditions not reported during the current year. This analysis provides critical insight and allows providers to close gaps in member evaluation, care and documentation of conditions.

Take Your Insights to a New Level

Prospective gap identification focuses on issues related to potential unreported medical conditions. Leveraging CMS RAPS returns as well as medical, pharmacy, lab values and DME claims data, we are able to identify suspect medical conditions not yet reported. Targeting the most likely medical records helps lower your overall risk adjustment administrative expenses and improve your ROI. The bottom line: our platform sorts through your data and tells you where to focus your team’s energy to have the greatest impact on your risk goals.

Benefits:

  • Improved member risk scores
  • Boosted member satisfaction measures
  • Increased efficiencies and quality assurance

Harnessing the Power of Prospective Gap Identification

Our experienced team has a deep understanding of your health plan and the risk associated with each area. Our ultimate objective is to enable you to provide better care for more members and helping manage risk is an important step in that goal.

If you worry about the gaps in your plan, let’s talk about how we can help.

Find Out How We Fuel Accelerated Performance

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