LOS ANGELES--(BUSINESS WIRE)--Clear Vision Information Systems announced today the launch of MDMax, a full-service, outsourced solution designed to improve the quality of care for Medicare Advantage members by proactively identifying gaps in their care and facilitating an office visit with their physicians.
“Identifying gaps in care, especially for seniors and those with chronic conditions, is one of the most important things we can do to support both the patient and the physician,” said Tom Peterson, president and CEO of Clear Vision. “Patients often need to be reminded when basic screenings are due or when it’s time for a routine or follow-up physician visit. MDMax is a much-needed product at the right time.”
Already an industry leader in healthcare data collection, Clear Vision offers MDMax to health plans that may not have the resources or tools available to identify members at greatest risk or to put a plan together to reach out to those individuals. “MDMax is a prospective outsourced solution that combines member outreach, provider engagement, data collection and coding to make the system work better for everyone,” says Peterson.
With MDMax, Clear Vision works with the health plan to create a list of Medicare Advantage members who have not recently seen their primary care doctor or who have a chronic condition that requires follow-up. The health plan may target specific physician groups, geographic regions or any criteria they wish to establish.
These members are contacted by phone, reminded of their need, and encouraged to make an appointment. If they wish, Clear Vision can make the appointment for them on the spot. Clear Vision then tracks follow-up and, working with certified coders, captures diagnosis codes from physician progress notes and reports incremental diagnoses and HCCs (hierarchical condition categories as established by the Centers for Medicare and Medicaid Services) back to the client.
“This is truly a program that benefits everyone,” says Peterson. “The members get the care they need, and the health plans and doctors do a better job of keeping their members and patients healthy while receiving all of the reimbursement dollars to which they are entitled.”
As Peterson points out, a program like this is particularly important today as CMS has begun paying Medicare Advantage plans based on the quality they provide to their members as determined by such factors as clinical outcomes, access to preventive services such as screenings and vaccines, managing chronic conditions, preventive care, and consumer satisfaction.
MDMax is part of a suite of services Clear Vision offers medical groups and health plans. Other portfolio products include: RevMaxPro, one of healthcare’s most powerful and easy-to-use data-intelligence tools that provides health plans and providers an integrated view of their Medicare Advantage members; DXMax, a retrospective outsource solution for hospital data collection that puts an end to missed and under-reported inpatient stay diagnosis codes; and SubmissionMax, a single-click diagnosis code identification and correction software that helps health plans easily manage and correct CMS-rejected diagnoses.
Clear Vision Information Systems provides Medicare Advantage risk adjustment solutions and strategies to health plans and providers nationwide. Leveraging decades of experience at the forefront of Medicare policy, Clear Vision’s portfolio of products and services – including risk adjustment analytics and easy-to-implement continuity-of-care strategies – helps clients maximize their revenue while improving quality of care. For further information, visit www.cvinfosys.com.