Are you missing out on significant reimbursement because of inaccurate EDGE reporting? Wish you had more control over your risk adjustment submissions?

With our comprehensive risk adjustment solution for EDGE, Babel Health puts you — not your vendor or IT department — in the driver’s seat. Manage your encounter data submissions with new ease and efficiency … from data import to acceptance and reconciliation. Get valuable, real-time insights into the financial and risk performance of your Marketplace programs to support swift and smart decision-making.

Babel Health’s risk submission management solution for EDGE allows you to:

  • Import any file format, and easily map and transform data to conform to guidelines
  • Validate data records against CMS edits prior to submission
  • Rank and prioritize error correction activities by risk/revenue
  • Analyze holistic revenue gaps — orphans, enrollment, claims and supplemental, non-claims based information
  • Concurrently measure progress to forecasted actuarial goals
  • Identify trends and provider education opportunities
  • Analyze data and produce detailed ad hoc reports

Get An ‘Edge’ in Recapturing Lost Revenue

As an ACA plan, you’re required to pull off a skilled balancing act between the demands of the government, MLR, actuarial forecasting and member needs. Babel Health can help maintain control all of those pieces. Our platform speeds and simplifies the risk adjustment process while improving accuracy and compliance. Reduce error correction work, improve acceptance rates and positively impact your health plan’s revenue.

With the time savings and peace of mind our solution provides, you can focus your efforts where they’re needed most — on providing quality healthcare to your members.

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RAPS/EDPS Medicare & Medicare Advantage
EDGE Affordable Care Act (ACA)
APCD All-Player Claims Databases