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Provider Engagement Coordination (PEC) Program

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Provider Engagement Coordination (PEC) Program

Proven Provider Engagement for Improved Performance

Our Provider Engagement Coordination Program works directly with providers to review coding, improve documentation and identify gaps to improve accuracy and enhance care.

Successfully managing risk requires more than just addressing issues within the walls of your health plan. Since the quality of your claims data rely heavily on the providers that care for your members, it is vital that they be included in your risk initiatives. True provider engagement requires integrating with provider workflows in a way that helps them monitor, report and improve patient care.

Proven Solutions to Engage your Providers

Every day presents you with new challenges and even more stringent documentation requirements to meet. The prospective Provider Engagement Coordination (PEC) Program focuses on assisting your providers with complete and compliant documentation to improve member risk score accuracy, Star ratings, and quality of care.

Your provider practices work with in-market Provider Engagement Coordinators to improve medical record documentation and accuracy of member risk scores. If your providers need additional education focused on medical record documentation requirements, we deploy on-staff Medical Directors dedicated to peer-to-peer collaboration.

  • Proprietary process for generating and distributing clinical alerts
  • Record reviews to identify documentation opportunities
  • In-market provider engagement coordinators
  • On-staff medical directors dedicated to peer-to-peer collaboration and education
  • Physician reviewer and certified coder teams
  • A provider-centric approach
  • Accelerated implementation

Client Performance

  • Risk score accuracy improvement of .200 after second full program year
  • Increased Star ratings by an average of 5%

The PEC Program Works

The Advantasure PEC Program features physician-led provider education, physician reviewer and certified coder teams, and record reviews to identify documentation opportunities. The PECs and Medical Directors strive to build relationships with your providers to reinforce educational topics and assist with adoption of high-performance strategies into their regular daily workflow. With our understanding of the challenges that your plan, and your providers, face each day, we have developed a solution to create alignment and revolutionize how you interact with this crucial stakeholder group.

Our PEC Program has consistently improved documentation rate accuracy and has been shown to reduce risk for our customers. Let’s connect and discover how we can engage your providers to accelerate your plan’s success.

Extend Functionality: Add-on Solutions

  • Remote clinical documentation improvement
  • Two-way review and claims validation
  • Stars data abstraction

Find Out How We Fuel Accelerated Performance

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