1. health and fitness

Integrated solutions
for health plans
and providers
• Risk Adjustment Analytics
• HEDIS and Stars Tracking
• Inpatient Data Pursuit
• Patient and Provider Outreach, Coding
and Data Collection
• CMS-Rejected Diagnosis Tracking
and Correction
www.cvinfosys.com
or (888) 778-9899
Integrated solutions for
health plans and providers
Discover Clear Vision
RevMaxPro™
Turnkey, hosted Medicare risk adjustment analytic software
integral to care management, finance and compliance
Fully hosted, easy to implement and use, RevMaxPro™ is a Medicare risk adjustment
software solution that delivers data transparency for health plans and providers.
RevMaxPro is a powerful, easy-to-use tool that provides actionable information in
managing patient populations and related RAF scores, thus driving CMS revenue. In
addition to managing risk scores, RevMaxPro integrates HEDIS and Stars monitoring to
support quality initiatives.
• Dashboards and reports make it easy to track, trend and forecast risk
adjustment performance
• Run dozens of standard reports, plus create custom reports by filtering by plan,
provider group, PCP or member
• Create target lists for chart reviews, prospective office visits, home
assessments, and mock RADV audits
• Analyze data by HEDIS/Stars measure or diagnosis for care management
programs
• Create action plans by viewing prioritized reports showing combined HCC and
HEDIS/Stars gaps by provider
• Providers can view patient data from multiple health plans in one common
format and location
• Create pre-populated, patient specific evaluation forms to support chronic
condition follow up and HEDIS/Stars measures
• All reports can be downloaded into pdf or csv
RevMaxPro™ is fully compliant with CMS and HIPAA requirements. The risk adjustment
software automatically updates to reflect CMS risk adjustment methodology changes or
changes to Medicare regulations.
HEDIS / Stars Monitoring
HEDIS and Stars analytics that maximize care quality and outcomes
RevMaxPro™ allows plans and providers to gain efficiencies by integrating Medicare risk adjustment and
HEDIS/Stars prospective activities. All measures included in the application are NCQA certified.
The hosted, easy-to-use software application uses claims, lab and pharmacy data to give you:
• Integrated HCC and HEDIS/Stars gaps—Prioritization reports rank patients by number of missing
HCCs and quality measures so you know where to focus efforts. Results can be filtered by
physician group or PCP.
• Prospective intelligence at the point of care—Pre-populated health assessment forms for
physicians to use during patient visits.
• Performance results against benchmarks—Detailed report cards for Stars and HEDIS metrics that
monitor clinical results.
• Gap analysis by measure—sortable reports that make it easy to pinpoint opportunities by
measure and/or provider.
RevMaxPro contains a full suite of standardized reports to support quality care. The application offers
filtering customization options. Data can be downloaded for easy data mining.
MDMax™
Full outsource member outreach and provider collaboration to close care gaps
MDMax™ is a prospective end-to-end solution for closing care gaps. The service includes provider
engagement, member outreach, data collection, coding and data entry.
Leveraging our RevMaxPro™ platform, Clear Vision does all the legwork to close care gaps including:
• Generation of a target list of members with identified gaps
• Outreach to providers
• Outreach to members for appointment scheduling
• Development of patient-specific reporting to support providers when the patient is in the office
• Coding of physician’s progress notes
• Data entry of the additional and/or corrected data
• Reporting in client-specified submission format to make submission to CMS easy
• Scanning and indexing of documentation also available
Enhance continuity of care. Raise risk scores. Match CMS revenue with services delivered. MDMax™
makes it happen!
DxMax™
End-to-end inpatient data collection service
Hospital data pursuit is an important part of your Medicare risk adjustment program. DxMax™
puts an end to missed and under-reported inpatient stay diagnosis codes, giving health plans
the ability to correct inaccuracies or gaps when it counts—pre-CMS sweep.
Our inpatient data pursuit service uses advanced algorithms to target and obtain missing data.
We connect with hospitals and care facilities—over 6,000 participate nationwide—to collect
additional or corrected data. Leveraging our strong hospital relationships and negotiated rates,
Clear Vision employs a multi-step process that delivers economy of scale and frees your
internal resources.
Our DxMax service includes:
• Development of target lists and filtering strategy
• Multi-touch campaign including mail and outbound calls to maximize hospital response
• Data entry of all captured diagnosis codes including double keying to ensure 100%
accuracy
• Reporting in client specific format to process and package before sending codes
to CMS
• Scanning and indexing of documentation also available
Thorough capture of diagnosis codes provides early warning indicators for better medical and
quality management, while helping to right-size your CMS revenue.
Submission Max
Single click diagnosis code identification and correction
SubmissionMax is simple software that identifies and corrects RAPS errors—even after a claim has been
paid. SubmissionMax empowers health plans to:
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Efficiently manage your monthly CMS-reject processing
Analyze CMS files
Automatically identify CMS-rejects
Simplify corrections without having to reprocess a claim; many rejects can be corrected with a
single click
• Create a submission-ready file of corrected items for CMS
Client Service
Seamless Implementation
The Clear Vision team works side-by-side with you to ensure a quick and seamless implementation.
Included at no additional fee:
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New client orientation
Implementation project management
User training
Action planning
Training and Support
Behind every Clear Vision solution comes a breadth of personalized training and product support.
You can count on:
• New user training
• Bi-monthly user groups
• Educational webinars
• Ongoing information on best practices
• Newsletters
• Anytime access to our team of experts
Discover Clear Vision
Our Company
Clear Vision Information Systems was founded in 2006. Our founding partners, Tom
Peterson and Pam Klugman, have been involved in Medicare risk adjustment since
its adoption by CMS in 1997. Collectively, the company principals have over fifty
years of experience in managed health care, Medicare risk adjustment and
reimbursement. Our founders are recognized industry experts who understand the
unique challenges faced by plans and providers. We are located in Westlake Village,
California. Our support and services are provided by employees located in Southern
California; we do not off-shore any of our operations.
Our Team
We have assembled a team of experts with deep experience in risk adjustment,
HEDIS measurement, technology, finance, operations, customer service, analytics
and organizational development.
Our company values are based on integrity, trust, teamwork, innovation, and
profitability. These values guide our business approach on a daily basis.
Our Customers
We work with health plans and providers of all sizes, ranging from start-ups to well
established national organizations. Our customers include a wide variety of local,
regional and national plans across the country. MSO's and provider groups of all
sizes use our software and services.
For more information contact us at
www.cvinfosys.com or (888) 778-9899