Wellness Appointment Outreach
Risk adjustment is an essential mechanism in accounting for the overall health and expected medical costs of our members. Accurate documentation of diagnoses by clinicians is a critical component of the risk adjustment process.
QualChoice has established a prospective risk adjustment program including telephonic outreach to assist at-risk members in scheduling their annual wellness visits. A list of high-risk members is generated monthly. Dedicated analysts then connect the member and provider by phone to schedule the visit. The provider receives a cover letter and patient profile and the member receives an appointment reminder prior to the visit. Letters are also sent to members who have been unreachable by phone. As an incentive, the member receives a $100 gift credit card when we receive the wellness visit claim.
We appreciate your help in scheduling these visits and in helping manage our risk adjustment!