EXL Health risk adjustment & quality solutions

EXL Risk Adjustment

EXL Health looks and goes deeper to find a better way

EXL Health’s modular, end-to-end risk adjustment and quality management solutions deliver optimized performance on risk-adjusted populations, including improvements across clinical documentation, quality outcomes and accurate reimbursement.

By combining deep domain expertise, cutting-edge technology, and advanced analytics, we help you achieve accurate risk and quality scores. Our AAPC-certified risk adjustment and quality services cover the full spectrum of support and are designed to meet our clients where they are on their value-based transformation journey. We partner closely with our clients to identify and engage the right patients at the right time to ensure they receive high-quality, coordinated care.

Who we serve

EXL Health partners with and delivers our clinical services to both health plan payer and provider organizations. We support driving value-based outcomes and transformation in order to support improvements to member health outcomes, medical cost containment and quality compliance.

Payers

Supporting payers in identifying and decreasing administrative waste, reducing overall health claim expenditures, and optimizing revenue opportunities while improving member care quality and effectively managing population risk.

Providers

Serving provider organizations looking to proactively manage risk, improve quality outcomes and optimize network performance.

What we do:

At EXL Health, our risk adjustment, quality management, and analytics services enable our clients to get the most accurate results. We offer a full suite of effective risk & quality services and work with clients to develop the right program for their goals. These services include:

Analytics

Member Targeting & Prioritization
Gap Identification & Closure
Coding Effectiveness & Analytics
Performance Evaluation & Forecasting
Financial Forecasting

Operations

NLP Driven Chart Review Services
Submissions
Coding - Staff Augmentation
Bi-directional EMR integration
Chart Retrieval
Provider Education & Engagement
Member Engagement

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Industry analysts recognize our excellence

EXL Health’s Risk Adjustment and Quality Management organization embodies human ingenuity to propel the success of our clients by solving their most complex problems. We take a relentless approach to getting results and deliver outcomes through a highly flexible, collaborative and responsive approach, enabling us to form strong, long-lasting partnerships with our clients who look to EXL Health as a strategic partner today, tomorrow and for years to come.

It’s one of the reasons why EXL Health was named Best in KLAS 2022 for Risk Adjustment, with 100% of our customers stating that they would purchase EXLCLARITY™ again