From commercial group to Medicare Advantage and Medicaid managed care, Lumiknox supports the full back-office stack — risk adjustment, HEDIS, STARS, RADV, claims operations, and analytics — under one delivery model.
Regional Blues, national MA plans, Medicaid MCOs, dual-eligible programs, ACA marketplace issuers.
Whether you’re running one line of business or all of them, our pods configure to your platform, your accreditation calendar, and your commercial model. We don’t force you onto our process — we embed inside yours.
HEDIS submission, RADV response, sweep season — and they all overlap. We provide surge capacity that scales in 14 days.
v28 transition, audit sample sizes growing, statistical extrapolation playing larger. Our two-pass coding holds up.
Tukey deletion and tightening cut points punish complacency. We model your cut-point exposure quarterly.
Your senior coders and abstractors are leaving. We backfill in 30 days and let your A-team focus on judgment work.
Inpatient, outpatient, profee, and HCC coding by AHIMA- and AAPC-credentialed coders. Concurrent or retrospective. Onshore-supervised, with …
ExploreSolution 02 · QualityHybrid measure abstraction by certified clinical abstractors, with overread by RN-credentialed QA. We hit your IDSS submission window — and …
ExploreSolution 03 · PerformanceMember-level gap closure programs, CAHPS readiness, Part D medication adherence, and HEDIS-Star alignment for plans below 4.0 — or holding 4…
ExploreSolution 04 · RiskFrom sweep season to CMS or HHS RADV audit response, Lumiknox provides chart retrieval, second-level coding review, encounter data fixes, an…
ExploreSolution 07 · IntelligenceOur applied-AI team builds, trains, and operates predictive models that live inside your operations — HCC recapture propensity, member lapse…
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