A Prospective Healthcare Risk Adjustment Solution
CARAT is an expert system that applies Artificial Intelligence (AI) through Natural Language Processing (NLP), optical character recognition (OCR) and machine learning (ML) to coding and documentation to transform risk adjustment from a purely retrospective financial transaction into a prospective activity that drives improved care and compliance.
Prospective risk adjustment analyzes the patient record for insight into gaps and newly emerging conditions to support real-time patient care
Retrospective risk adjustment analysis to ensure your charts are as accurate as possible
CoderAssist™ optimizes coder productivity with suggested ICD-10 and HCC codes and validation of M.E.A.T. criteria
ProviderAssist™ prompts provider to close gaps, fulfill M.E.A.T. criteria, and respond to coder enquiries
HOW CARAT WORKS
Providers spend a significant amount of time in chart review, with thousands of pieces of data stored in PDFs, images, or unmapped fields, it can be easy to miss an undocumented or newly emerging patient condition.
CARAT leverages optical character recognition (OCR) and natural language processing (NLP) to find and make sense of all of this data in real-time to assist providers at the point of care.
Applying Actionable Intelligence
from Clinical Documentation & Claims Data
CARAT’s AI applies machine learning (ML) to analyze healthcare and financial or claims data to look for insight that surface patient conditions and opportunities to close gaps in coding and documentation.
Directly within the EHR, CARAT ProviderAssist provides a checklist of actions to close retrospective gaps and trigger management and evaluation of each patient condition, right when it’s needed – at the point of care.
Clinical Improvement Activities
Fulfill M.E.A.T. Opportunities at the Point of Care
Even before the encounter, CARAT has profiled the entire patient record to look for clinical insights at the point of care to support clinical decision making. CARAT ProviderAssist walks the provider through M.E.A.T. criteria for each chronic condition in the patient record, documenting each step back to the EHR. This real-time support reduces RADV audit risk and transforms risk adjustment into a patient-care activity.
Save Valuable Time for Providers
CARAT analyzes and normalizes the data in the EHR to suggest ICD-10 and HCC codes with accuracy up to 95% in real-time, all accessed within the EHR. At the same time, CARAT can assist in identifying any provider documentation issues that may impact quality and reimbursement. CARAT takes all the guesswork out of coding, streamlining coding and M.E.A.T. validation down to less than 5 minutes per day.
Review data for your entire population to efficiently monitor risk scores. Stratify your population by applying filters by provider type, eligibility, or risk adjustment factor objective.
Seamless integration with telehealth solutions ensures that telemedicine encounters are properly coded for risk adjustment whether the provider documents in his/her own EHR or uses the telehealth vendor documentation option.
CARAT is built upon secure, scalable technology supported by single sign-on (SSO) technology. As a trusted business associate, Cybexys adheres to important data security and compliance regulations in healthcare including HIPAA-HITECH. Cybexys regularly audits and updates technical and process protections to ensure the protection, integrity, and availability of its systems and services.