Prospective clinical reviews occur prior to the point of care. Highly effective clinical review teams utilize clinicians and clinical coders to assess diagnostics, health history, medication lists, treatment plans, imaging reports, and additional clinical documentation to capture diagnoses that aren’t inherently visible to the treating physician. Our AI-based approach provides intelligent insights into the patient-provider interaction by delivering qualified conditions with supporting logic to the physicians ahead of the date of service. Our proprietary integration process that allows us to push prospective diagnosis into any EMR.
Our prospective risk review services:
- Assess opportunities for complete diagnoses
- Complete EMR integration
- NLP scrubbing
- Enhance specificity to enable accurate risk scores
- Provider education
- Diagnostic inference from ancillary documentation