Geisinger Health Plan Implements Coding Insight By Talix To Streamline Risk-Adjusted Coding

Risk adjustment application helps identify coding gaps and increase coding efficiency

Talix, Inc., a premier provider of healthcare risk management solutions, recently announced that Geisinger Health Plan (GHP), an innovative, not-for-profit insurance organization based in Danville, Penn., has implemented Talix’s Coding InSight application to automate and streamline risk adjustment processes. The application helps professional risk adjustment coders at GHP effectively uncover missed Hierarchical Condition Category (HCC ­) codes in member charts, close coding gaps, and improve coding accuracy and efficiency.

“We strive to achieve the highest level of quality. Accurate coding provides a complete member medical condition result,” said Karena Weikel, ASA, vice president of risk and revenue management at GHP. “As our member population grows, we need an advanced coding solution to help improve our productivity so we can support increasing workloads while still maintaining our high quality standards. The Coding InSight application will help us effectively identify uncoded or miscoded opportunities with more accuracy and efficiency.”

Powered by the Talix HealthData Engine, Coding InSight combines advanced natural language processing (NLP) technology, sophisticated clinical rules and a proprietary medical taxonomy to analyze member data from disparate sources, such as claims, electronic medical records and scanned paper documents, to accurately identify missed codes.

Coding InSight integrates with Geisinger Health System’s clinical systems to provide GHP with a unified solution and a feature-rich coder workspace to manage workflows, workloads and assignments. As a result, more missed chronic conditions and documentation gaps are uncovered, coding accuracy is validated, and coding efficiency and productivity is increased.

“The manual coding process is time-intensive and often costly, which presents a tremendous pain point for many health plans around the country,” said Dean Stephens, CEO of Talix. “Automating and streamlining this laborious process has a big impact on coder productivity and accuracy, resulting in much-needed cost savings. With Coding InSight, Geisinger Health Plan will benefit from an integrated, customizable and streamlined workflow for more accurate, efficient and complete coding performance.”

About Geisinger Health Plan
Geisinger Health Plan, begun in 1985, is headquartered in Danville, Pennsylvania. Geisinger Health Plan’s HMO, PPO and Geisinger Gold’s HMO are among the highest-rated private and Medicare health plans in the nation.^* The plan serves approximately 554,000 members in Pennsylvania, Delaware and Maine. Coverage is available for businesses of all sizes, individuals and families, Medicare beneficiaries, Children’s Health Insurance Program and Medical Assistance recipients. For more information, visit TheHealthPlan.com.

About Talix
Talix provides healthcare risk management solutions to help providers, payers and accountable care organizations address the challenges of value-based healthcare and risk-based contracts. Its SaaS applications leverage patient data analytics to turn structured and unstructured health data into actionable insights that drive improved coding efficiency and accuracy for more accurate risk adjustment, leading to better patient outcomes and reduced costs. For more information, visit www.talix.com.

^*NCQA’s Private and Medicare Health Insurance Plan Ratings 2016-2017. Geisinger Health Plan’s PPO is listed in NCQA Health Insurance Plan Ratings under Geisinger Quality Options. Geisinger Gold HMO is listed in NCQA Health Insurance Plan Ratings under Geisinger Health Plan.