Risk Adjustment and Analytics

Using advanced analytics, our experts design risk adjustment programs, resolve data issues, and improve provider documentation.

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What CMS received, what it accepted, and what that did to your risk scores.

Our Approach to Risk Adjustment and Analytics

Through innovative and efficient approaches, KIRSHA empowers MAPD plans to achieve sustainable growth, enhance performance, and deliver exceptional care to their members.

Data Driven

Data-Driven Strategies

We rebuild risk scores from your claims and CMS’s own reports.

Compliance Focused

Compliance Focused

Our strategies align with CMS requirements, minimizing compliance risks and helping to avoid potential penalties.

Submission Gaps

Submission Gaps

We compare your claims to your MAO-004 files. That shows diagnoses CMS never accepted, and diagnoses it accepted that your claims don’t show.

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Data Processing

Empower plans to make informed decisions, and achieve long-term success.

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Advisory and Consultation

Advice on risk adjustment programs and the CMS rules behind them.

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