At Cognisight™, we know providers & plans because we are providers and plan leaders. We were born out of Greater Rochester Independent Practice Association (GRIPA), a 881-physician member organization. We have intimate knowledge of physician and hospital workflow, claims processing, Medicare, and managed care. We understand all sides of the Medicare Advantage equation.We offer both retrospective and prospective risk adjustment services.

Retrospective

Our CognisightDX™ solution was built by clinical and industry experts who understand reimbursement coding practices and the challenges you face every day. We know you need correct and complete ICD 9 coding to be reimbursed properly for your services.

CognisightDX is not just a product. It’s an expert system that takes into account all the issues and applications required for Medicare Advantage reimbursement. While ICD 9 CM coding guidelines are a component of the analytics, we also apply in-depth predictive clinical logic to understand care provided and anticipated needs.

Our Retrospective Services are provided on a contingency basis, so we don’t get paid until you get paid.

Prospective

The Cognisight Assessments Program is a targeted, multi dimensional in-home evaluation. It is conducted by a CMS approved healthcare provider and accurately captures the health status of your members. It provides an opportunity to improve your plans quality measures.

Committed to our customers

We know that the financial health of your organization and the physical health of your members depend on timely and complete CMS reimbursements. We’re dedicated to giving you the information you need to ensure that you receive the full payments to which you’re entitled, measure your quality efforts, and support your disease management programs.

An end-to-end service

We don’t just consider the diagnoses contained in the HCC formula model. We consider the clinical path that precedes and follows those diagnostic results. Our goal is to help your organization receive appropriate reimbursement, enable care management, and measure quality performance.

No risk. Just rewards

You provide us with the information we need, we’ll provide you with an expected return and a proven path to achieve that return.

It’s that simple.

You have nothing to lose, so get in touch with us to learn what we can do for your organization.