IRIS was built for PACE clinical,financial, and compliance, teamsto optimize workflows and driveconsistent risk adjustment results.
The system provides coding validation, real-time analytics,and revenue integrity tools with targeted audits and education to drive performance improvement.
Coding and Validation using Natural LanguageProcessing (NLP) technology focusing on relevant conditions that map to an HCC or RxHCC, saving timeand reducing workload burden, ensuring audit readinessand a seamless transition from RAPS to EDPS.
Real Time Analytics to trigger the next best actionfor HCC capture and recapture year over year and a Revenue Integrity module for payment reconciliationfor payment predictability.
Targeted Audits and Education as needed and drivenfrom analytics to ensure action on deficiencies combined with Provider education for performance improvement. Retrospective reviews and Mock RADV support available for additional compliance.