Superior Technology and Quality Improvement Methods
to Enhance Healthcare and
Service Excellence
Industry Leading Financial Results
HCC Management
Leprechaun provides clients with robust Risk Adjustment Solutions to identify and
comprehensively document the health status of the high risk population of the
health plan. This enables the health plan to implement care management strategies
and develop individualized care plans for these members as well as obtain
appropriate reimbursements from CMS.
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Retrospective Solution
Leprechaun was an original developer of Retrospective review. Our proprietary
algorithms sift through claims data and identify targeted opportunities for
incomplete coding. Member charts are retrieved, reviewed and coded by certified
professional coders who undergo stringent QA review. Detailed financial,
provider, and member analysis reports as well as RAPS file support complete
a thorough evaluation of patient charts to assure revenue maximization.
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Prospective Solution
Leprechaun has firsthand knowledge of providing integrated solutions through our
Prospective program. Our proven and secure technology populates our customized
evaluation form which is designed to accurately document chronic conditions,
capturing a snapshot of the member’s health. Our goal is to document conditions
correctly, accurately and completely in order to appropriately maximize your
revenue. Supported by state of the art reporting and expert project management,
Leprechaun supports HEDIS/Stars efforts as well.
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RADV Audit Support
Leprechaun is uniquely positioned and qualified to offer clients vital support to
assess their potential audit risk and/or assist a health plan through the complex
audit process.
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For more information, please contact our Business Development Team:
Kevin Murray, Regional Vice President, Business Development
847-829-4778
kmurray@lepmed.com
Kim Staley, Director, Business Development
817-231-7069
kstaley@lepmed.com
