HEX HCC Risk Management
Prospective and retrospective tracking of HCC conditions and scores with full out-of-the box support for CMS HCC model.
Hexplora provides an end-to-end solution for prospective and retrospective tracking of HCC conditions and scores with full out-of-the box support for CMS HCC model. Hexplora leverages intelligent business rules for identifying diagnosis gaps based on the following criteria:
- Missed diagnosis codes from historical diagnosis data
- Potential diagnosis codes that are correlated with specialist visits
- Identification of Chronic and acute conditions based on HCC and non-HCC models
- Potential comorbidities based on identified conditions
- Possible HCC conditions correlated with Quality measures
- Cost and utilization Trends
Hexplora’s application offers a guided review process that enables the Providers to easily review the diagnosis gaps and validate and confirm the presence or absence of the gaps in order to capture the accurate and full risk of the patient.