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For organizations participating in Alternate Payment Mechanisms (APMs) like ACOs, Medicare Advantage etc. the ability to enable providers to identify the best codes for optimal HCC scores, close quality gaps at the point of care, and ensure that they will be reimbursed for radiology services can make the difference between making or losing money.
CareTrak collects, integrates, and analyzes clinical (from multiple EHRS), claims, and SDOH data to identify all the appropriate HCC codes and quality gaps across all APMs as well as provides the AUC CDS mechanism to ensure that Medicare will pay for any imaging tests performed.”
Benefits of Using CareTrak
CareTrak brings all the right information at your fingertips to help deliver the best patient care
• Seamlessly integrates with athenahealth to meet your value-based care needs
• Delivers AI-driven clinical insights and care gaps
• Allows you to monitor and close HEDIS gaps
• Helps improve HCC Coding
• Enables you to review goals and care Plans
• Supports Annual Wellness Visits and other assessments
• Supports Telemedicine appointments
• Helps meet the radiology AUC mandate
CareTrak is designed to integrate in your existing workflow like a dream to optimize operational efficiency and boost revenue generation.
Data integration Collects data from all available sources (EHRs, claims, SDOH, patient reported, devices etc.). This data is then semantically normalized into standard terminologies, processed thru our eMPI and combined into a single standardized longitudinal record. This single record can then be viewed by the provider at the point of care.
HCC Coding. Supports the provider at the point of care by analyzing both the structured and unstructured data in the patient’s consolidated medical record to ensure that each patient in a risk program (like Medicare Advantage) has the most appropriate diagnoses documented to ensure optimal HCC coding. The app tracks which patient record the provider is viewing in Cerner and displays suggestions for any missing or more appropriate diagnosis codes based on that patient's longitudinal record. .
Quality care gaps Supports the provider in improving quality by presenting quality related care gaps derived from the consolidated longitudinal patient record. The quality gaps can cover any quality program that the provider is involved in, including HEDIS, Commercial, ACO, MIPS etc.
AUC From Jan 2023 onwards CMS will require that any provider ordering any advanced diagnostic imaging services (MRI, PET, CT scans etc.) must consult a CMS qualified Clinical Decision Support Mechanism (qCDSM) prior to placing the order. The qCDSM must generate and provide the ordering provider a unique code which can be used to trace that such a consult happened prior to the order being placed. CareTrak allows the provider to fulfill this requirement at the point of care without requiring them to leave Cerner.