Ramp Up Your Revenue with CognisightDX™

If you are still relying on current claims information to produce the member information required under CMS’s new Medicare Advantage reimbursement formula, your Medicare Advantage Plan is missing significant revenue. There is a disconnect between actual coding and billing practices and the information the Centers for Medicare and Medicaid Services must receive to provide your company with the correct payment for individual members.

Cognisight™ has your organization covered with a state-of-the-art system that understands clinical disease pathways, ICD 9 CM coding guidelines, and CMS requirements. CognisightDx will identify submittable diagnoses that are missing from your claim data and provide a path to collect them in order to right-size your member reimbursement and support your disease management efforts.

Our CognisightDX solution efficiently provides you with actionable information and a proven process to measurably and appropriately improve your bottom line.

It’s Easy—and Profitable—to Get Started with CognisightDX

First Steps: Data and Projected Revenue

The process begins with a data file. We’ll tell you what data you need to provide. (Don’t worry: we’re fully HIPAA compliant.) You create the file and we process your information.

Then we’ll tell you how much additional revenue you can expect to capture. When you see our results, we think you’ll agree that there isn’t a minute to waste.

Analytics Driven by Clinical Knowledge

We have developed our analytics first from a clinical perspective. The next layer of logic applies ICD 9 CM coding guidelines, both hospital- (inpatient and outpatient) and provider-specific. Following the application of clinical and coding rules, CMS managed care guidelines and HCC-specific logic are applied.

The results are consistent, clinically valid, ICD 9 compliant, CMS acceptable, actionable output.

Pinpoint, Foolproof Audits

Cognisight delivers a targeted electronic audit tool and a tested process to verify our findings. We tell you which hospital, which practice, which physician, which member, and where to locate each individual diagnosis. We provide the audit process and a tested timeline, along with a Cognisight Account Manager who will support you throughout the process.

Our proprietary audit is up to six times faster than a standard manual chart audit and requires no special skills on the part of the auditor, just the ability to read a medical record. Auditor subjectivity is virtually eliminated.

Transparency in Real Time

Throughout the entire process, you have access to the work that's been done and the progress that's been made. Real-time monitoring gives you confidence that performance expectations are being met.

Security Above All

We take HIPAA seriously. We don’t cut corners. Everything we do is in full compliance with HIPAA requirements.

The CognisightDX process couldn’t be easier to implement. Or more profitable. Contact us to learn how you can put it to work for your organization.