Completing Apixio’s Apicare Prospective Suite™, Post-Visit Workflow Leverages Class-Leading AI to Automate & Scale Review Process, Improve Risk Capture Accuracy, & Enable Value-Based Care

SAN MATEO, Calif., Feb. 21, 2023—Apixio, a leading AI platform that powers value-based care, today announced the launch of its new Apicare Post-Visit™ offering, an EHR-integrated intelligent workflow solution for health plans and providers. With the Centers for Medicare & Medicaid Services’ recent Medicare Advantage Risk Adjustment Data Validation Final Rule, healthcare organizations need to have complete diagnosis capture and accurate documentation for reimbursement to ensure compliance.

The new Post-Visit solution completes Apixio’s Apicare Prospective Suite™, which also includes Apicare Pre-Visit®, an EHR-integrated solution that optimizes the clinical chart prep process by surfacing insights of suspected conditions from structured and unstructured data, as well as Apicare Point-of-Care™, which pushes risk gaps to clinicians within the EHR workflow for risk capture. This comprehensive approach to prospective reviews helps health organizations achieve faster workflows to reduce administrative burden, drive more reliable financial performance, and deliver insights to improve patient outcomes.

Concurrent reviews are conducted immediately after the patient encounter prior to claims submission to ensure the diagnosis coding is accurate and supported by the patient encounter documentation. Completing these processes manually is an extensive endeavor consequently creating significant backlogs in the administrative processes. This burden contributes to provider staff abrasion, inaccurate risk capture, and potentially incomplete documentation of patient conditions to support value-based care workflows.

Apixio’s Post-Visit solution solves these problems with an AI-driven workflow that mines through encounter data immediately following a patient visit to surface ICDs. Its intelligent work queue prioritizes encounters for review, surfaces high-confidence diagnoses to accept, remove, or add, and allows reviewers to send queries into the EHR workflow for clinical validation. This fully digitized process improves the accuracy and completeness of diagnosis documentation.

“With the launch of our concurrent solution, Apixio is excited to round out our Apicare Prospective Suite to support healthcare organizations as they look to drive operational efficiency and support patient care delivery in a sustainable value-based care orientation,” Apixio CEO Sachin Patel said. “Our Apicare Post-Visit solution empowers collaboration across healthcare organizations and improves outcomes.”

With Apicare Post-Visit, organizations can:

• Capture both risk-adjustable (HCCs) and non-risk-adjustable codes to gain a comprehensive and complete view of the health of a patient
• Leverage a centralized workflow for real-time review status tracking and timeline management, providing users insight into how long reconciliation windows are open and how much time remains
• Improve risk capture completeness and accuracy to drive value-based care across Medicare Advantage (MA), Medicare Shared Saving Program (MSSP), ACO REACH, and other alternative payment models
• Resolve discrepancies before risk adjustment submission to support compliance alignment

Apixio will be exhibiting at RISE National 2023, March 6 – 8, 2023, and presenting an education session, Driving Organizational Alignment Utilizing AI for a Prospective Risk Adjustment Strategy. The session will take place on Tuesday, March 7, at 2:15 PM MT.

To learn more about Apixio’s complete Prospective Suite, visit www.apixio.com/clinical-guidance.

About Apixio
Apixio is advancing healthcare with data-driven intelligence and analytics. Our Artificial Intelligence platform gives organizations across the healthcare spectrum the power to mine clinical information at scale, creating novel insights that will change the way healthcare is measured, care is delivered, and discoveries are made.

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