New Quality and Risk Adjustment Solution from Nuance Combines AI and Coding to Deliver Context-Aware, Personalized Clinical Guidance to Providers
BURLINGTON, Mass. and SAN FRANCISCO, October 11, 2017 – Nuance Communications, Inc. and Talix, Inc. today announced a reseller agreement to deliver a new patient-focused solution to support better outcomes and risk adjustment through decision support and automation.
As a result of this agreement, Nuance introduced a new Nuance Quality and Risk Adjustment solution that combines Talix’s risk adjustment coding technology with Nuance’s artificial intelligence (AI)-powered Computer-Assisted Physician Documentation (CAPD) solutions. This new offering from Nuance will enable population health specialists, care providers and coders to quickly and easily find and close coding gaps at the point of care, and properly code high value risk adjustment opportunities.
With the emergence of new care and payment models, providers are shouldering an increasing amount of accountability and financial risk while also needing to provide comprehensive care and disease management across the continuum of care in a dynamic, value-based environment. As care increasingly shifts toward an ambulatory setting, effective population health management strategies that proactively identify and assess high-risk patients, and improve clinical documentation, are becoming essential for success.
The Nuance Quality and Risk Adjustment solution analyzes structured and unstructured health information and provides in-workflow intelligence that delivers context-aware, personalized clinical guidance at the point of decision making to help providers identify opportunities to close care gaps. This leads to better clinician engagement, planning, treatment and patient care, as well as streamlines effective reimbursement coding. The solution can increase coding accuracy and efficiency to improve productivity by two to three times and can improve risk score accuracy by up to 20%.
The new offering provides physicians and coders with the ability to capture a more comprehensive picture of each patient’s chronic conditions, helping to create a more coordinated, proactive and compliant practice. The combined solution:
- Identifies gaps in care intervention opportunities prior to and during the current patient encounter
- Ensures providers document requirements for Hierarchical Condition Category (HCC) coding and achieve accurate Risk Adjustment Factor (RAF) scores, while confirming that no conditions are missed by recapturing previously confirmed HCCs via a compliant process
- Drives better care and accurate reimbursement through complete capture of diagnosis, complications and comorbidities (CC/MCC)
- Automates extraction of diagnosis codes to save time and resources, while ensuring properly documented codes make it to claims the first time
The Nuance Quality and Risk Adjustment solution features automated chart review, in-workflow clinical guidance and analytics, and coding workspace for population health and HCC coding specialists. Nuance also offers various process improvement and educational services that ensure the technology is adopted by practitioners in a way that provides the intended clinical and financial benefits.
“This solution builds on Nuance’s decades of clinical expertise, technology innovation and experience with EHR workflows that are designed to optimize provider engagement, productivity and satisfaction,” said Michael Clark, SVP Clinical Documentation Solutions, Nuance. “Our relationship with Talix brings this expertise to the ambulatory care setting and enables providers to focus more on patient care, while capturing the details necessary for accurate reimbursement and proper risk adjustment performance.”
The solution also features Talix’s extensive health taxonomy – developed and continually refined over the last fifteen years – and purpose-built natural language processing (NLP) technology to expedite complex risk adjustment coding processes. This provides highly accurate, real-time HCC code recommendations directly from physician notes, which are then made available to providers through Nuance’s deep integration with electronic health record (EHR) systems.
“Health plans are increasingly transferring the financial risk of member care onto provider organizations, motivating physicians to look for technology enabled, user-friendly solutions that will improve both patient outcomes and financial performance, and MACRA only accelerates this marketplace evolution,” said Dean Stephens, CEO of Talix. “Our relationship with Nuance is focused on putting a powerful integrated tool into the hands of physicians through the EHRs they are already using that will help them utilize their time more effectively, realize more accurate reimbursements and most critically, deliver better care to their patients.”
“Talix has transformed the coding and risk adjustment processes for Village Family Practice,” said Clive Fields, M.D., president of Village Family Practice. “It has improved not only coding efficiency, but more importantly, the level of care we’re able to provide to our patients. As a practice, we are now coding for care rather than for dollars.”
To learn more about the Nuance Quality and Risk Adjustment solution and how it improves care quality and risk adjustment at the point of decision making, visit booth #715 at AHIMA’s 89th Annual Convention & Exhibit in Los Angeles, CA. For more information:
- Register for this webinar – Marilyn Garry, senior director of risk adjustment and quality at Talix, will host a webinar on October 20, 2017 from 2 – 3pm ET titled, “Navigating Coding Workflows: Workflow Best Practices for Improving Risk Adjustment Coding.”
- View this data sheet – Learn more about patient-focused, just-in-time intervention management that engages providers.
Nuance provides a more natural and insightful approach to clinical documentation, freeing clinicians to spend more time caring for patients. Nuance healthcare solutions capture and communicate more than 300 million patient stories each year helping more than 500,000 clinicians in 10,000 healthcare organizations globally. Nuance’s award-winning clinical speech recognition, medical transcription, CDI, coding, quality and medical imaging solutions provide a more complete and accurate view of patient care, which drives meaningful clinical and financial outcomes.
Talix provides risk adjustment and quality solutions that help providers, payers and accountable care organizations take on financial risk and succeed in value-based healthcare. Our leading-edge SaaS applications leverage best in class, proprietary NLP, machine learning and advanced in-workflow designs to transform complex data into actionable intelligence that drives improved coding efficiency and accuracy—leading to better patient outcomes, more accurate reimbursements and reduced costs. For more information, please visit www.talix.com or follow @TalixHealth on Twitter.
About Nuance Communications, Inc.
Nuance Communications, Inc. is a leading provider of voice and language solutions for businesses and consumers around the world. Its technologies, applications and services make the user experience more compelling by transforming the way people interact with devices and systems. Every day, millions of users and thousands of businesses experience Nuance’s proven applications. For more information, please visit www.nuance.com.
Trademark reference: Nuance and the Nuance logo are registered trademarks or trademarks of Nuance Communications, Inc. or its affiliates in the United States and/or other countries. All other trademarks referenced herein are the property of their respective owners.
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