Member Risk Score Monitoring (MRM)
Our Member Risk Score Monitoring (MRM) platform empowers Risk Adjustment and Financial Risk professionals with Plan and Member MLR tracking, HCC Surveillance and improved, chronic HCC recapture rate.
Plan Performance
Monitor Plan Performance by Product and Sub-Populations
Track Plan and Member Level Medical Loss Ratio.
Analyze Risk Scores and Claims trends by product and sub-populations.
Member Diagnosis
Improve Revenue Accuracy
Track Calendar RAF over time.
Monitor and Improve Chronic HCC recapture rate.
HCC surveillance tools enable you to track members with few and rare conditions.
Encounter Submission Management
Improve Encounter Submission Health
Ensure timelines of encounter data submissions.
Review encounter acceptance and rejection rates by claim types and providers.
Identify and correct common errors.
Engage providers to address frequent submission errors.
RAF Modeling
Reduce Member Churn Rate
The average churn rate of MA plans is 10%. Achieving a 1% improvement per 100k members increases revenue by 9.6M. RAF Modeling helps you understand the impact of members leaving the plan.
