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AaNeelCare® – Revenue Max

Revenue Max comprises of MRA and 5 Star Rating. Health Risk Assessment is a way of determining whether an individual or group has a risk. 5 Star Rating is introduced as part of an effort to help educate consumers on quality and make quality data more transparent.

AaNeelCare® – Revenue Max

AaNeelCare - Revenue Max comprises of MRA – Medicare Risk Adjustment and 5 Star Ranking. MRA aids in substantiating documentation for diagnoses and also helps in perspective health assessment that in return maximizes your revenues. 5 Star Ranking is introduced as part of an effort to help educate consumers on quality and make quality data more transparent.

Health risk assessment is a way of determining whether an individual or group has a risk that is a deviation from the average. Individuals who are expected to incur higher health spending are considered relatively worse (i.e., higher) risks than those who are expected to incur lower spending.

MRA
Health risk assessment is a means of objectively determining whether an individual or group represents a risk that is reasonably close to the population average and, if not, of quantifying the relative deviation from the average. Individuals who are expected to incur higher health spending are considered relatively worse (i.e., higher) risks than those who are expected to incur lower spending.

In risk adjustment, a third party, such as the federal government or a state, collects and organizes data from insurance claims and clinical diagnoses for all enrollees in every participating health plan or provider organization in a particular market. Using what’s known as a risk-assessment tool or methodology, this entity then converts the data into a risk score for each person. Individual risk scores are then aggregated into an overall score for each insurance plan.

In practice, individual risk scores, built from data on patient demographics, disability, institutional status, and diagnoses, are used to help determine monthly payments made to plans for each person enrolled in Medicare Advantage, Medicare Part D prescription drug benefits, and many state Medicaid managed care programs.
5 Star Ranking
5 Star Ranking is introduced as part of an effort to help educate consumers on quality and make quality data more transparent. The ratings comprises of over 50 measures from 5 different rating systems. They are:

HEDIS (Healthcare Effectiveness Data and Information Set)

CAHPS (Consumer Assessment of Healthcare Providers and Systems)

CMS (Centers for Medicare and Medicaid Services)

HOS (Health Outcomes Survey)

IRE (Independent Review Entity)

Based on the technical specifications given by CMS, rates and scores are calculated and stars are graded on a contract level. CMS Stars ratings are published annually and are available for all Medicare members. Plan members use the star ratings as a way to compare performance among several plans when choosing their enrollment. Ratings range from 1 to 5 stars, with five being the highest and one being the lowest score. Medicare reviews plan performances each year and releases new star ratings each fall which means plan ratings change from one year to the next.

Plans are rated on how well they perform in 5 different categories:

1. Staying healthy: screenings, tests, and vaccines

2. Managing chronic (long‑term) conditions

3. Member experience with the health plan

4. Member complaints, problems getting services, and improvement in the health plan’s performance

5. Health plan customer service

By Using our AaNeelCare® – QM, practices can achieve good star rankings. The criteria, the denominator and numerator, exclusions for each measure is fed into the system. As a result, there would be alerts & notifications indicating there is a criteria that has to be met to fulfill any measure.

Testimonial

AaNeelCare® is very as customized and individualized. They analyze and assess our needs before presenting us with the required modules for our setting. Depending on for what healthcare environment do you need this technology, whether it is a physician office using only EMR or a hospital, and then they customize the product to those needs. They also scale the requirements as per our demands as we grow. AaNeelCare® provided us with all the things we were looking for. They had the modules, they had the integration, they had the right technology, and they were the kind of company we liked working with. Their customer support is awesome.

AaNeelCare® is very user friendly. You are able to move from one screen to another quickly. There is no much clicking required as in other EHRs , we’ve worked with.

The functionality of this product is excellent. It provides efficiency and is user friendly. It is well-designed to capture the modern technology we use today.

This software is user-friendly enough for each person in your office, even for the not so computer savvy users! Most of the modules are simple and easy to use, all the icons are simple to navigate and make life easier.

AaNeelCare® has been absolutely a pleasure to work with. We could not have moved as quickly as we have without AaNeelCare®’s constant support and monitoring of our progress as we implemented this product.

I'd highly recommend AaNeelCare® to Physicians and hospitals for this allows complete and precise maintenance of patient records, saving lots of time and money. The software not only helps in management but also in improving the quality of medical practices and processes as it reduces manual errors.

Thank you all, for an absolutely fantastic product that meets all our needs under one roof that is so incredibly logical and user friendly. I’m so happy that there is something out there that actually works, even when compared to big names in the market. If all my fingers were thumbs I would give 10 thumbs up!