Driven by Data. Inspired by Outcomes.
Enabling Technology Platform
Tessellate’s Enabling Technology Platform provides you the means
to drive overall performance and compliance of submissions.
Our Software-as-a-Service (SaaS) platform was built to serve
the healthcare Risk Adjustment industry including Medicare
Advantage and Commercial ACA. Our integrated suite of modules
work hand-in-hand, providing all the insights you need for success.
Our platform allows you to achieve greater levels of plan/provider
collaboration by consolidating functions into one interactive
tool. With this robust platform, you can harness the power of data to achieve your goals. Our modules go beyond
the basic filter and search functionalities. The Tessellate platform allows you to toggle between summary and
detailed views; drill-down from a report result set to view detailed information; access member, claim, and provider
information; and export reports into a PDF or Microsoft Excel format. Unique to the platform is your ability to
search for records at the member or provider level through physician view. The platform includes tools for Suspect
Analytics, Risk Management, MA Enrollment and Financial Reconciliation, Medical Record Review (MRR), and more.
Financial reporting
Management oversight
Retrospective operations
⊲
Monthly revenue reconciliation
report
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Dashboards
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Suspect analysis
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User activity
⊲
⊲
Financial forecast report
⊲
Resource management
Retrieval scheduler with
Geomapping
⊲
Dropped HCCs report
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MRR Coding
⊲
PCP RAF report
Clinical reporting
⊲
Coder performance
⊲
Project improvement report
⊲
Member profile report
⊲
Status review by chart, note or
provider
⊲
PCP disease management
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Financial outcomes
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Provider engagement and
profile
⊲
RAPS/EDPS filtering and file
generation
⊲
Suspect toolbox
Prospective operations
⊲
HRA scheduler
⊲
HRA schedule status report
tessellate.com
Why Tessellate?
At Tessellate, our goal is to help you succeed. We are a leader in the health care industry offering proven
solutions to health plans and providers that demonstrate improved Risk Score accuracy, reduced RADV
audit risk and increased Star Ratings. Regardless if you are new to Medicare Advantage or simply want to
improve upon your current success, we will collaborate with you to offer technology-enabled, multiplepoint services, designed to achieve your goals. Our end-to-end Risk Adjustment and Quality programs bring
together every piece of the puzzle to form seamless strategies that will improve revenue integrity and lower
your administrative costs. These solutions are provider-centric, less abrasive and quickly implemented. With a
client-first commitment, Tessellate has an established track record of delivering value and quality, and we are
proud to offer our innovative and comprehensive portfolio of services:
⊲
Comprehensive Medicare Advantage Risk Adjustment and Quality Program
⊲
Prospective Provider Engagement Coordination Program
⊲
Retrospective Chart Retrieval and Review
⊲
Medicare Advantage Risk Adjustment Program
⊲
Medicare Advantage Quality Improvement Program
⊲
RAPS and EDPS Submissions
⊲
In-Home Assessments
⊲
Enabling Technology Platform (health plan and provider)
Tessellate by the numbers:
⊲
Serves more than 1 million Medicare Advantage and Commercial members
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Operates in over 20 states and Puerto Rico
⊲
Manages over $5 billion in risk adjustment related revenue
⊲
Delivers over $300 million in quality related bonus revenue
⊲
Achieved 4-Star rating for a National PPO plan year-over-year for the past four years
To learn more about Tessellate:
804.977.0500
[email protected]
tessellate.com
©2017 Tessellate LLC. Proprietary. All rights reserved.
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