Medicare Advantage and PACE HCC Risk Management you can trust

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What We Do


Risk Adjustment Payment Analysis

Analyze risk score trends to isolate areas that need improving.

Retrospective and Prospective Member Chart Reviews

DxID offers a chart review process which combs through medical records to ensure all diagnoses have been accounted for.

Customized Financial Reporting

Slice your reimbursement by plan benefit package, county, and disease state and use to gain invaluable insight into your member population.

Bid Rate Support

As the blended benchmark changes, bid rates will become increasingly complex. We help you understand, analyze, and plan for the bid process.

Clinical and Population Reporting

Customized reports by beneficiary, provider, and disease state are priceless clinical tools. Using our proprietary DxAnalyzer, we help organizations track chronic diseases and develop plans for early intervention.

Health Risk Assessments

Knowing your beneficiaries is the key to providing quality care. We work with organizations to develop, implement, and retrieve health risk assessments that help organizations be confident they are doing all they can.

Processing of Claims to the Risk Adjustment Processing System
(RAPS)

While the Centers for Medicare and Medicaid Services gear up for encounter data, it is crucial for plans to ensure their RAPS submissions are accurate. DxID ensures diagnoses are captured in accordance with CMS guidelines.

Encounter Data

The future of risk adjustment hinges on encounter data. We work with organizations to gather, format, prepare, test and submit encounter data in 5010 compliant formats, regardless of the present state. Ask us how we can help you with Encounter Data.

Risk Adjustment Data
Validation Support
(RADV)

Our staff is experienced with national and targeted RADV audit management. Mitigate your risk of logistical error and let us support your RADV audit. We promise to collect every medical record and provide logical, supporting documentation for each and every valid submission.

What our clients say


Provider Office Feedback

DxID surveys each office by phone following the review
100% satisfaction rate
(96% of the offices called responded to the survey)

Our experience with DxID has been tremendously valuable already and we have only known them for about 8 months. We have already seen great benefits in terms of revenue as well as education. I have been consistently impressed with their professionalism, organization, security measures, and expertise. They are truly a partner in improving our PACE program.

All the reviewers have been exceptionally professional, very unobtrusive, and have been doing exceptional work

Great as you guys don’t make us print records and send them. You are one of the few companies that will travel to complete the review.

Leadership


Each and every member of our staff understands health care.
We are experts in technology, medical coding, physician documentation, claims processing, and risk adjustment.

Betsy Gaffney

Founder / CEO

Betsy brings more than twenty years of experience on the technology and business side of health care, including product development, sales and marketing, strategic planning and development, and management. She possesses particular expertise in the field of electronic medical records and billing systems, and has held positions with health care providers and health care technology firms throughout the northeast.

Gino Startari

Director, Finance

Gino is responsible for the financial accounting operations of DxID including financial reports and a comprehensive set of controls and budgets designed to mitigate risk, enhance the accuracy of the company's reported financial results, and ensure that reported results comply with generally accepted accounting principles.

Jennifer Doran

Director, Clinical
& Administrative Operations

Jenn brings more than a decade of experience to DxID. She oversees both the administrative operations staff as well as the clinical staff. These teams flex with the demands of our clients needs throughout the year and Jenn manages it all with a results driven approach.

Brian Milne

Director, Technology

Brian brings two decades of experience to DxID with a keen sense for managing teams and systems that deliver value on time and under budget. He brings tremendous value to the leadership team at DxID which stems from a background in both software and hardware engineering and the risk adjustment industry.

John Haughton

Consulting Risk Adjustment Advisor

Dr. Haughton brings over twenty years of experience in health care research and clinical application of predictive modeling and risk adjustment to DxID as a physician and an engineer.

As Consulting Risk Adjustment Advisor, Dr. Haughton consults with DxID to support the interpretation of risk adjustment rules as they apply to Medicare Advantage and PACE formularies and technology tool development.

Let's Get In Touch!


Ready to start your next project with us? That's great! We hope to hear from you soon!

333 West Commercial St
Suite 3000
East Rochester, NY 14445

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855-855-DxID / 855-855-3943

Toll Free Fax: 844-248-3943