Did you know we have been providing Risk Adjustment Services since 2006?

For the past ten years Gentry Consulting has been providing risk adjustment (RA) related services for health plans and health systems.   Our primary business is Risk Adjustment and we provide flexibility solutions for Medicare Advantage, Affordable Care Act (ACA), and Managed Medicaid plans.  Through proven processes and exacting use of technology, we are able to provide a ranges of services, from full-service to a la cart.  No matter how you choose to access our services, rest assured you will have the peace of mind of knowing we've got you covered.

RA Accuracy- Risk score improvement services to identified under-reported and/or inaccurate health conditions.  Services can be all all inclusive or as requested:

  • Analytics of plan data to optimize population selection for risk score accuracy review
  • Medical record/ chart acquisition (via request by mail, remote EMR, or onsite as appropriate to each unique client)
  • Chart review and medical coding with least disruption to provider community
  • Chart review results captured electronically using secure, proprietary technology and processes that
    • includes capture of all properly documented and support diagnoses (not just RA related)
    • includes embedded risk adjustment model that automatically maps any diagnoses that trigger RA condition (improved coding efficiency)
    • allows for the capture of additional, important information such as documentation issues, unsupported but billed diagnoses, or need for follow-up actions
    • allows for real-time reporting
  • Electronic results submission
  • Full project management
  • In depth status reporting

RA Validation Audit(RADV)- Full service support for responding to regulatory validation audits of risk score accuracy.

  • Medicare Advantage Risk Adjustment Validation Audits
  • HHS-ACA Risk Adjustment Validation Audits and Initial Validation Audit services

RA Consulting- Solutions to help you maximize your existing risk adjustment program.

  • RA software vendor evaluation/replacement
  • Process evaluation and improvement
  • Evaluate opportunities to bring outsourced RA functions in-house