Risk Adjustment HCC Coding Solutions

Virtual Oplossing Healthcare’ Payer Solutions further develops government payers and hazard-bearing suppliers the executives of agreements. Our payer arrangements permit customers to further develop their danger change and quality projects by giving them a total stage that gives them significant information and answers for follow-up on them.


With the biggest wellbeing plans and medical services associations as customers, Virtual Oplossing Healthcare is very much regarded for giving probably the most noteworthy outcomes in the business around hazard change coding (HCC coding), HEDIS deliberation, and recovery. This is refined with an innovation empowered stage, excellent venture the board, and center around customer fulfillment. We collaborate with our customers to accentuate straightforwardness and trust and like the chance to turn into an important expansion of your group consistently. 


Our exclusive innovation stage gives adaptability to pick the administrations and stages you should be effective. We give worldwide assets and an assortment of administrations, work processes, and stages – which can all be redone to your necessities.

Our Risk Adjustment Services

Taking advantage of hazard change programs requires the right innovation and assets with a specialist center around hazard change. This accompanies an inside and out assessment and a 360 degree take a gander at your information and drives. An external look is regularly the best method to genuinely take care of business. Regardless of whether you’re a payer or a danger-bearing supplier, we ensure you get the right RAF score and assist you with augmenting the effect. Our danger change stage gives an exact, constant glance at your danger scores – in view of a far-reaching and progressing survey of your information. Our demonstrated assistance conveyance model takes diagram survey to the most significant level, guaranteeing idealness, quality, exact documentation, and ideal outcomes.


Our services include:

Medical Record Retrieval

Virtual Oplossing is focused on gathering each applicable clinical record, coding everyone effectively, and conveying dependable, precise outcomes. Our exclusive iCode innovation and supplier touchy cycles support more noteworthy commitment and fulfillment among suppliers. Graph recuperation techniques offer suppliers a great deal of adaptability and decrease supplier scraped areas. They are HIPAA-agreeable, tried, and secure; they incorporate supplier gateways with simplified ability, EMR mix, and EMR CCD information trade alongside on location recovery, fax, and mail. Our interesting dashboard gives full straightforwardness into constant graph recovery status.

HCC Coding

We offer chart review options that give you flexibility and allow you to affect RAF score and documentation improvement:


Concurrent Chart Review

  • Provides an immediate review of the record.
  • Review risk adjustment conditions at the time of visit.
  • The real-time query for provider clarification.

Retrospective Chart Review

  • Blind coding reviews.
  • Claims data validation.
  • Identify opportunities for provider education/training.

Inside each audit, we support your association’s endeavors to catch all danger changed analyses and guarantee individuals are fittingly hazard changed. Our completely utilized group of more than 2,000 coders can scale rapidly and complete activities of any size. We offer a full-administration HCC coding answer for all danger change coding: ACA-Commercial, Medicare Advantage, and Managed Medicaid. Our consistent based way to deal with clinical record coding is conveyed by AAPC or AHIMA confirmed coders who catch or recommend cancellation of hazard changing symptomatic codes and can likewise perform information approval reviews. Virtual Oplossing coders are prepared to distinguish conditions for supplier instruction that don’t meet CMS measures dependent on documentation. This data is bundled in significant reports.


RAF Score Reporting

Virtual Oplossing constant danger change detail dashboard and revealing delineate your arrangement, gathering and down to the individuals’ absolute RAF score. We can show increases and cancellations of determination and what it means for your general RAF score and how to further develop it with appropriate schooling and documentation.



Our HEDIS solutions provide a real-time look at your performance – allowing payers to improve care delivery, quality, and member satisfaction.

  • Best record approach to find the right measures in the right place.
  • Built-in workflow for external overreads and MRRV audits.
  • Maintaining cost-effective practices.
  • Unprecedented transparency using Virtual Oplossing  web-based management platform.

Provider Education and Support

Our supplier schooling stage gives you a far-reaching perspective to distinguish openings for supplier instruction and input. Our foundation permits you to audit moving reports and training by supplier, strength, or HCC class. This permits you to see where you need to give your suppliers schooling and permits you to show them how their outcomes contrast with the general wellbeing plans, gatherings, and friends.


Risk Bearing Providers

With more than 100 supplier customers, Virtual Oplossing is profoundly established in the supplier market. We see how to function with supplier gatherings and assist them with getting the most out not just their danger change and quality projects program yet the capacity to offer arrangements that address every one of their issues including proficient charge coding, A/R, patient contact, and other RCM arrangements. 

Our restrictive undertaking innovation stage tends to basic problem areas for payers with its diagram recovery highlight, simultaneous survey capacities, and capacity to catch HEDIS and STAR measures. Virtual Oplossing’ iCode Risk Adjustment innovation is a wise work process instrument utilized by payers to perform hazard change and quality drives using a self-administration apparatus. It additionally gives you the adaptability to utilize inner and merchant assets that best meets your requirements.