Risk Adjustment Optimization
Lightbeam's integrated solutions empower providers to optimize risk adjustment coding, ensuring accurate reimbursement and improved financial performance.
Organizations struggle to balance accuracy, compliance, and efficiency in capturing patient risk. Fragmented data, documentation gaps, and regulatory scrutiny undermine both financial performance and care delivery.
EHR silos, missing encounters, and poor SDOH
capture lead to inaccurate risk scores.
CMS updates and stricter reviews increase
compliance risk and financial exposure.
Clinician burnout and inconsistent workflows result
in missed or incorrect diagnoses.
Disconnected teams and limited resources hinder coordination across clinical, coding, and analytics.
Lightbeam’s Risk Adjustment Optimization Solution (Provider Compass) empowers providers to improve diagnosis coding accuracy, optimize HCC risk adjustment, and maximize reimbursement. Embedded directly in EMR workflows, Provider Compass automates alerts and guidance, reducing administrative burden and coding errors.
- Embed AI-powered HCC coding guidance directly into EMR workflows.
- Automate alerts, reporting, and follow-up to reduce audit risk and maximize revenue.
- Deliver dynamic dashboards and reporting for transparency and strategic planning.
- Reduce friction with real-time coding support and recapture opportunities.
- Automate right time delivery of reports and patient lists to care teams.
- Improve RAF scores and ensure appropriate reimbursement.
Provider Compass is Lightbeam’s embedded, AI-powered solution that delivers real-time HCC coding guidance directly within the provider’s EMR workflow. Without requiring a separate login or external portal, Provider Compass automatically surfaces critical information, such as quality measure gaps, risk scores, and HCC coding opportunities, at the point of care. Daily updates ensure the latest insights are always available, helping providers take timely, informed action that improves both care and reimbursement accuracy.
- Eliminates Frustration of Toggling between portals
- Automates EMR Alerts for Patients with Quality Measure Gaps or Risk Adjustment Recapture/Suspect Coding Opportunities
- Expands within the EMR to display patient-specific details
- Consolidates and Displays Patient Treatment history in Summary Tab
- Strengthens Risk Adjustment Precision
- Provides Real-Time Visibility Into Patient Records
Enables Augusta Health to Improve Health Care in Their Community
Augusta Health, a nonprofit community health system in Fishersville, Virginia, comprising a 275-bed hospital and an ACO managing care for 17,000 lives, deployed Lightbeam’s population health management platform, including the Cohort Builder and ADT Insights Dashboard, to better identify and manage high-risk patients, improve care coordination, and address social determinants of health through community partnerships.
For the first 90 patients enrolled in Augusta Health’s high-risk cohort, the program is averaging approximately a:
