Medicare Risk Adjustment Services

From prospective review services that provide a complete picture of a Medicare Advantage plan member’s health status to retrospective review services that uncover complete diagnoses, EMSI offers solutions for both to ensure proper risk factor identification.

With our Home Visit Services, we perform mobile medical examinations for Medicare Advantage plan members to review health conditions, including those that may previously have been unidentified.

Our Medical Chart Review Services support retrospective review initiatives by gathering all applicable medical records on members to support accurate diagnoses and audit reporting.

Medical Chart Retrieval

Securing all member medical records is essential to successful retrospective review initiatives. EMSI is the undisputed leader in medical record collection with over 35 years of experience and as the largest provider of medical record retrieval services in the industry.

EMSI offers complete, detailed chart collection to capture diagnoses and treatments for the most accurate HCC coding and CMS reimbursement, as well as compliance with RADV and OIG audits. With our expertise and targeted approach, we manage large record collection projects through our centralized call center while ensuring quality standards and specific timelines. We can handle the details of a full range of requirements, including:

  • Provider verification, including signature and specialty credentials.
  • Provider address and contact information.
  • Patient name/identity.
  • Dates of treatment/services.
  • Medical record fee reimbursement management.
  • Image quality and indexing specifications.

EMSI can supply you with consistent, national handling of medical chart retrieval services for optimal quality, efficiency, affordability and the most appropriate CMS reimbursement.