Healthcare Services
Professional Healthcare Services USA
HEDIS® Consulting, Compliance & Performance Improvement
We assist healthcare organizations with data optimization and regulatory compliance, offering end-to-end HEDIS support to track, measure, and enhance care quality. Our services include data collection, validation, gap analysis, custom solutions for NCQA accreditation, and strategies to improve patient outcomes and reporting accuracy.
Skilled Nursing Facilities (SNFs) Data Validation
Our consulting services help Skilled Nursing Facilities prepare for CMS validation reviews by identifying compliance gaps, improving documentation, and aligning operations with current CMS standards.
Medicare Advantage Data Validation
Ensuring accuracy in Medicare Advantage data validation is crucial for regulatory compliance and reporting. Our Medicare Advantage services include:
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Comprehensive data validation for CMS compliance.
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Performance metric audits to enhance care outcomes.
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Reporting and analytics to optimize operational efficiency.
Independent Validation Audits (IVA)
Our IVA services are designed to prepare organizations for official CMS validation by providing an objective, third-party assessment of readiness and compliance. We conduct comprehensive audits that mirror CMS review protocols, identifying potential risks and areas for improvement before the formal validation process.
Risk Adjustment
HealthSpective delivers end-to-end risk adjustment medical coding services that enhance accuracy, compliance, and reimbursement through certified expertise, comprehensive coding support, HCC validation, audit readiness, clinical documentation improvement, and advanced reporting aligned with CMS guidelines.
URAC Measures Consulting
As a URAC data validation expert, HealthSpective assists healthcare organizations in achieving URAC accreditation by ensuring compliance with high-quality standards. We provide:
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Data validation consultation to meet URAC requirements
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Support for accreditation in case management, telehealth, and other programs.
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Comprehensive compliance reviews and process enhancements.