AI-Driven Risk Adjustment Software

 Increase the profitability of your Medicare risk contracts

ForeSee ESP® software significantly enhances your RAF scores and boosts HCC coding productivity by 5 to 10 times. Utilizing advanced disease detection algorithms and machine learning-based natural language processing, it efficiently processes patient data throughout the healthcare system. By leveraging AI, we identify diseases from existing text notes and EHR data, providing real-time, insightful HCC risk adjustment support directly integrated into your EHR system.

transition with ease between

V24 and V28 frameworks

Be prepared for the 2024 healthcare changes with ForeSee’s built-in V24 to V28 Optimizer®. The feature simplifies the complexities of both HCC models, presenting blended RAF scores in both 1/3 and 2/3 ratios. Each code is tagged to its corresponding V24 and V28 HCC model. This enables dual recapture utilizing both models ensuring users are not only ready for the transition but positioned to thrive within it.

For patients with a disease that maps to a v24 and v28 HCC, choose the most relevant ICD.

When V24 and V28 RAF scores for a set of ICD codes for the same disease are equivalent – select a code that maps to both models, this will facilitate recapture.

SAVE TIME AND MONEY

Get it right the first time

Prospective decision support and retrospective review options ensure your Medicare risk adjustment coding is evidence-based and accurate. Improve your compliance, reduce work during sweep timeframes, and eliminate clerical bottlenecks by coding correctly at the point of care. Make life easier with clinical decision support at the time of the encounter, or before. Because it always feels great to do something right the first time.

Keep it simple

Works the way you think

We know you think in terms of disease and not codes or risk adjustment categories, so our proprietary disease detection algorithm thinks the same way. Once a disease is detected, the coding and RAF scoring is easy. You get the recommended code for the disease and our HCC coding tool matches it to the risk adjustment category for scoring. Isn’t it nice when you can keep things simple?

it’s all yours

Designed the way you want

Developed by physicians and coders just like you, ForeSee ESP is cloud-based, designed to work on any device, and integrate seamlessly with your EHR. Simplify confusing codes (SNOMED to ICD10) and process your patient data in just about any format, including the latest FHIR APIs. Get decision support and using ForeSee’s exclusive InstaVu® feature, click links tracking the evidence back to the patient chart, including data extracted from text (PDF) notes. All presented in a streamlined, easy to understand format. Just the way you like it.

Case Study

Learn how this ForeSee client's strong performance led to its acquisition, resulting in a year-long EHR transition that temporarily paused services. Explore the impact on RAF scores before and after the transition.

our team is your team

We learn by listening to you

Our Executive Chairman and CEO are both board certified physicians and understand complex workflows. In our last venture, we listened carefully to the needs of healthcare professionals, and invented the first cloud-based EHR with touch technology on the iPad. It simplified the way providers interact with their patient’s health record and was top-rated by Medical Economics Magazine. This time around, you get the benefits of valuable lessons we’ve learned, our team knows how to transform complex workflows into a simple interface.

PROVIDERS

Get the data you need

We’ve reached the age of information overload. For many physicians it’s impossible to wade through months or years of medical records to determine the current disease burden / risk score of a patient. With ForeSee ESP, we do the reading for you, extracting clinical events and linking them to the original documentation, a real time saver. Clinical decision support is updated real-time so it’s available and accurate when you need it most - at the point of care. Your choice of the best ICD10 code is easy because the “likely used” codes are linked to the diseases you diagnose.

CODERS

Capture complete diagnoses

If you’re a coding expert, then you’ve probably observed many different workflows related to supporting the HCC coding effort. The good news is, we support both prospective and retrospective workflows. If you plan on adopting a prospective model, we make it easy for coders to help the physician plan for the upcoming encounter. Communication tools make the transmission of coding advice simple. Work lists and reports augment a retrospective review of HCC opportunities that may have been missed at the point of care.

ADMINISTRATORS

Allocate proper resources

Think of all the extra time and money spent on HCC tasks if accurate risk adjustment isn’t done right the first time, at the point of care. When ambiguity related to the disease burden of your patient population is reduced, the result is less inquires and faxes from coders and health plans. Use the ForeSee ESP Risk Adjustment Analyzer to track the medical group’s average patient risk score and compare to the projected score. Compare the risk score of segments of your medical group to be sure you allocate resources to those care teams that take care of the sickest patients.

QUALITY TEAMS

Improve health accuracy

Patients are watching, now many carry an abbreviated version of their medical record on their mobile device. Let’s make sure that the list of diseases they see on their device really matches their clinical state. Our clinical decision support facilitates up to date and accurate disease coding. Accuracy is what we all aim for, we understand that HCC auditors are not just examining the new codes that were found, they also want to know your process for finding inappropriate or old codes. Your group's Delete Suspects report displays already used codes for which there is no clinical evidence.