Medicare Advantage and PACE HCC risk management depends on your ability to get the full picture of health for every patient.

We’re DxID, and over the past eight years we’ve reviewed more than a million medical records with an average 96.85% inter-rater reliability. We provide both full managed services and software solutions designed to help payors more accurately gauge the risk associated with their member populations.

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About Us

Experience

As pioneers in risk adjustment coding, chart review services, proprietary review software and RADV support, we are the most qualified and trusted team in the industry. Our focus is to support plans and payors most likely to benefit from our expertise and business model.
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Accuracy

Our proprietary algorithms and processes are built on a solid understanding of medical practice and diagnostic requirements. We deliver efficient data collection, management and preparation—with triple review and analysis by experienced clinicians, certified coders, data experts and compliance professionals.

Trust

We’re your partners—with business model options that depend on getting results, transparent processes, content you can access anywhere and outcomes you can count on. Every time.
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What We Do

Medical Record Coding and Review

Complete peace of mind. DxID provides experienced, licensed clinicians who are certified coders to review 100% of medical records—retrospectively or concurrently. Every finding is supported by auditable content designed to comply with all applicable guidelines (CMS, ICD-10-CM, RADV, etc.) and is reviewed multiple times by our licensed clinicians. You’ll receive tested, transparent results.

Self Service Review

Our tools. Your talent. If you prefer to review your own records, DxID offers a suite of tools and training, including pre-programmed tablets and management dashboards. Easily collect and confidently submit files to CMS, with the option of additional review and testing by our dedicated quality assurance team of licensed clinician coders.

RAPS and EDPS Submission Services

End-to-end efficiency. DxID now provides CMS Submission Services for RAPS and EDPS—DxSubmit! No need to engage a third party when a single team can manage and implement your entire review process—from analytics to submission—with rigorous testing, transparency and detailed reporting. Monitor review progress, submission status, post-submission response details and monthly CMS reports all in a secure, cloud-based, fully HIPAA-compliant environment.

RADV Solutions

Support when and where you need it most. DxID reviews 100% of documentation in your medical records, gathering support for any HCCs identified by CMS for RADV review—all the way through to provision of (CMS) CDAT-ready submission files. We’ll work closely with you throughout the audit to provide rationale for coding decisions and back-up for clinical decisions. After the audit, we’ll assist you in creating processes and tests to anticipate and eliminate future risk.

DxID Document Management Solutions

Reduce provider abrasion, avoid multiple, repetitive record pulls and simplify record management storage with our secure, easy to use document management system. Supports enhanced annual visits, ACA, RADV and HEDIS content accessibility, and integrates with our Provider Contact Management system.

Services

Clinical Risk Analysis

Analyze risk score trends to better anticipate member needs and support better plan design.

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.

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.

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.

Provider Profiling

By population or patient, disease-specific or use, quality metrics and incentives, disease management and support services.

Patient Profiling

Individual demographics and contacts, conditions and treatments, contacts and preferences, safety and access choices.

Provider Contact Management System

Provider-specific CRM tracks and monitors provider interactions across the organization. Manage provider access requirements and calendaring for seamless communication with provider base and transparency across departments.

Leadership

Betsy Gaffney

Founder / CEO
Ms. Gaffney 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 management. As a recognized innovator in the field of electronic medical records and billing systems, she has held positions with health care providers and health care technology firms throughout the northeast.

Gino Startari

Director, Finance
Mr. Startari 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 rigorous accounting principles.

Jennifer Doran

Director, Clinical & Administrative Operations
Ms. Doran brings more than a decade of experience to DxID. She oversees both administrative operations and clinical staff. These teams flex with the demands of our clients’ needs throughout the year, and she manages it with a results-driven approach.

Brian Milne

Director, Technology
Mr. Milne brings two decades of experience to DxID, along with his ability to manage teams and systems to deliver results on time and under budget. With a background in both software and hardware engineering, as well as experience in the risk adjustment industry, he brings tremendous value to the DxID leadership team.
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What Our Clients Say

Payors trust DxID to deliver results, as demonstrated by our unique no-upfront-cost business model, á la carte offerings and the recommendations of our clients. You can trust our insights and accuracy, driven by full-time, highly experienced review teams of licensed clinicians with coding certifications and exhaustive knowledge of CMS requirements.
Providers appreciate our transparent, painless, non-disruptive and flexible review process, our customized support to their internal teams, our actionable tools and excellent outcomes—along with our hands-on, customized provider education and ability to support each PACE organization’s specific needs.

"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."
"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."

Get in Touch

Get better with a more accurate picture of participant health. Let’s start with a free consultation.

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