- Chart-Based HCC Discovery
- MEAT / TAMPER Verification
- Reduce Risk Leakage
Identify Missed Conditions. Protect Revenue. Strengthen RAF.
Retrospective Review evaluates patient documentation after the date of service, giving organizations a complete and detailed look at chronic conditions, coding accuracy, and missing supporting elements. We help you recover overlooked HCCs, correct discrepancies, and prepare audit-ready summaries for year-end submission cycles.
Our Retrospective Review Services
HCC Gap Identification
Find chronic conditions that were treated but not documented or coded correctly during the year.
Documentation Sufficiency Check
Ensure each diagnosis meets documentation guidelines including MEAT or TAMPER validation.
Coding Accuracy & Error Review
Identify coding inconsistencies, unsupported diagnoses, and opportunities for corrected submissions.
Provider Clarification Queries
Send targeted queries to clinicians to reconcile unclear or incomplete documentation.
Audit-Ready Condition Summaries
Package findings into compliant summaries for risk adjustment submission and audit defense.
Year-End Risk Closure Support
Assist with final-year risk capture cycles, ensuring no chronic conditions are overlooked before deadline.
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Our Retrospective Review Workflow
Our structured retrospective workflow ensures all risk-impacting conditions are validated and supported with compliant documentation. This helps organizations catch previously missed opportunities and reduce future audit exposure.
Chart & Claims Intake
Gather all available patient records, including specialist notes, labs, imaging, and prior coding.
Clinical Indicator Review
Identify symptoms, encounters, or treatments suggesting undocumented chronic conditions.
HCC Mapping & Validation
Cross-check diagnoses with HCC models and validate with MEAT/TAMPER rules.
Query & Clarification
Request missing details or clarification from providers when documentation is incomplete.
Condition Summaries
Create audit-ready summaries for validated diagnoses.
Submission Support
Prepare findings for final risk adjustment submission or reconciliation cycles.
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Improve Your Operational Outcomes. Connect with us today for a no-charge in-depth Consultation before we begin optimizing your operations.
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