Your Risk Adjustment Partner

Elevate value and efficiency with our innovative healthcare payer solutions.

Payer

The Episource Clarity Platform is an end-to-end platform for risk adjustment and quality initiatives.

It delivers tangible outcomes for our nation’s leading risk-bearing providers by supporting all aspects of risk adjustment, including analytics, record retrieval, medical chart coding, and more — all while delivering superior client services, flexibility, and the ability to deliver at scale. Take advantage of our suite of tailored offerings designed to reduce provider burnout and enhance patient outcomes.

Episource Clarity Platform

Payer

Access

SAAS SOLUTION

Cloud-Based Platform Portal

Analyze

Risk Scoring, Analytics & Suspecting

EXPERT-LED SERVICES

Risk Adjustment Program Assessment

Compliance Review

SAAS SOLUTION

Acquire

Data Acquisition & Interoperability

EXPERT-LED SERVICES

Medical Record Retrieval

Direct EMR

Remote Automation

TECH-ENABLED SOLUTION

Code

NLP-Powered Medical Chart Coding

EXPERT-LED SERVICES

Pre-Visit Review

Concurrent Review

Retrospective Review

Final Check Review

Chart Audits

SAAS SOLUTION

Submit

Data Submission

EXPERT-LED SERVICES

Encounter Data Management

Financial Projections

SAAS SOLUTION

Our Offerings

Discover our full suite of products and services:

Our online client reporting portal, Episource Connect, delivers real-time project data in a secure and compliant environment. Track the status of your record retrievals, chart coding, and other risk adjustment projects with our easy-to-use platform.

Our risk adjustment analytics platform turns data into actionable insights at the touch of a button for Medicare Advantage, Medicaid, and ACA health plans, as well as provider groups.

Using our intelligent, cloud-based retrieval platform and NLP technology, Episource Hub gives provider groups timely electronic access to clinical data across disparate sources.

Episource Coder offers NLP-powered coding tools to empower payers and providers to code charts and audit in-house vendor work with more accuracy and efficiency.

Episource Submitter offers an integrated encounter data error management and submissions solution to streamline error corrections and prioritize based on risk score impact.

Risk Adjustment
Program Assessment

Leverage our risk adjustment analytics expertise to assess program performance. We’ll help you identify areas of opportunity, implement interventions, and measure the impact of your efforts over time.

Compliance 
Review

Generated by Episource Analyst, this comprehensive report identifies claims and conditions that are at high risk of regulatory audit. These results are segmented across four key categories of risk.

Medical Record
Retrieval

With more than 14 years of experience, we’ve streamlined the medical record retrieval process for health plans and their provider networks through a repeatable, scalable, and customizable approach.

Remote
Automation

Performing remote chart retrieval manually can be a cumbersome task, consuming valuable time and effort. The process of logging in, searching, and downloading charts can extend for days or even weeks, particularly with larger chases.

Direct
EMR

Our Direct EMR service can simplify this process for you. Our interoperability solution, Episource Hub, streamlines data exchange by providing a chase list detailing specific data requirements.

Concurrent
Review

Leverage our best-in-class NLP technology and our deep bench of experienced coders to efficiently identify confirmed and suspected diagnoses to document on your claims.

Retrospective
Review

Uncover unsubstantiated codes and improve clinical documentation accuracy with our comprehensive retrospective coding services, executed by the industry’s largest full-time coding team and our proprietary NLP engine.

Chart
Audits

We offer multiple levels of chart audit services that adapt to your workflow and provide unparalleled results. Choose the chart audit service based on your specific needs.

Final Check
Review

Final Check Review is an efficient, cost-effective second-level review of medical records that ensures over 95% coding accuracy and full compliance prior to submission.

Pre-Visit
Review

We analytically distill the year-over-year diagnoses and clinically-suspected diagnoses that clinicians can address — all in advance of a patient visit.

Why Partner with Us?

Industry Expertise

Benefit from our deep industry knowledge and insights, ensuring solutions that are tailored to your evolving needs.

Innovative Solutions

Stay ahead with our cutting-edge products designed to optimize efficiency and performance.

Dedicated Support

Our committed team is always ready to provide exceptional support, ensuring seamless integration and implementation of our solutions.

Value-Driven Approach

We are committed to delivering unmatched value, assisting health plans in achieving their revenue goals and excelling in a competitive market landscape.

Experience the Difference

with our healthcare payer solutions and services.

Partner with us and unlock the potential to deliver the best care possible to your members.