Data Utilities for Clinical Data Supplementation

Delivering added value from clinical data retrieval and redetermination efforts

Moving beyond the PDF to supplement clinical data, boost accuracy, insight, and value derived from clinical chart retrievals

Traditional retrieval campaigns conclude with the delivery of flat PDF files, leaving a plethora of untapped data and insight on the table. With the transformation to digital, records obtained can be mined for additional uses across the health plan to assist in making key decisions to improve the membership’s benefit.

Ciox Data Utilities offers tools that can be used together or individually, depending on need. Utilities include multiple offerings with Structured Data Delivery, and Social Determinant Insights.

Ciox Data Utilities Supplements Clinical Data by:

Offering flexible and scalable data interpretation toolsets that increases the value of charts retrieved
Expanding access to Chart Content and Supplemental Data across the organization
Delivering structured clinical data in electronic and easily consumable formats in the cloud
Simplifying your data utilization by accepting records directly retrieved from EHRs in Continuity of Care Documents (CCDs) or Clinical Document Architecture (CDA) formats
Adding multiple sources of data and chart content to enrich analytics and downstream use cases

Ciox Best Contact solves data accuracy challenges:

Fill in and augment patient profiles
Ensure care management and other outreach departments have current contact information
Leverage a unique identifier in place of sensitive information like SSNs and DOBs
Maintain information on highly-transient patients
Improve transparency into minor populations through public records linking

Structured Data Delivery

In today’s digital world, not everything begins that way. Even digital PDFs are sometimes lacking the structure needed to consume into your data analytics or send downstream to other departments. Ciox Data Utilities Structured Data Delivery serves the charts with the XML file of the CCDA that is retrieved from the EMR and processed via the Diameter Health Fusion engine. Fusion’s automated, scalable engine generates standards-based, normalized, and analytics-ready data from raw CCDs in near real-time. This allows your team to mine the data or use it to validate against other datasets to ensure you’ve captured the right information, enabling payers the ability to parse and ingest XML or JSON data into analytics and coding applications. It converts raw EMR-sourced CCDA/FHIR data, enabling information to be parsed, enriched, and shared within the health plan departments including population health, health informatics, medical economics, and more.

Social Determinant Insights

Know what your members are less likely to tell you or their providers, and gain additional information from the charts retrieved and assessed. Ciox Data Utilities Social Determinant Insights appends charts with over 400 attributes, demographic information including phone, address, email, and a deceased indicator, plus offers three risk scores including:

Medication Adherence Risk
Total Utilization Risk Score
Member Engagement Risk Score

Ciox Data Utilities Key Differentiators

Data provided via API or SFTP, whichever suits the need for your health plan
Delivers a single ZIP file containing the XML, RFT, and PDF per patient or Chart ID
Generate output data in industry-standard format (FHIR) that is portable and supported in the majority of healthcare data transactions
Extends the value of your risk adjustment chart chases across the organization to population health, revenue cycle, health informatics, medical economics, and more
Can be utilized individually or bundled to provide added value and insight
Unbinds data from flat PDF files to a more robust and digitally-enabled format
Removes noise from the data and improves the process for matching diagnoses
Converts unstructured data to structured for digital enablement
Improves preventative care efforts
Increases patient engagement
Reduces returned mail expenses
Lowers medical expenses from more effective clinical outreach programs
Improves engagement for better HEDIS/STAR ratings and patient satisfaction
Captures mortality data and updates contact information for use in redetermination and other member outreach

Risk Adjustment Solutions

Medicare Advantage, Medicaid, ACA & CMS Direct complete services & technology

Quality Medical Record Retrieval

HEDIS, RAD-V & STARS, Digital and Traditionally retrieved medical charts & abstraction

Business Intelligence

Pre & Post Chase Member analysis and insight

HCC Coding

On & Offshore Hierarchal Condition Category Coding Services

Second Level Review Coding

Cross Check – NLP & Machine Learning powered 2LR Coding service

Digital Connectivity

Ciox Digital Direct™ identifies electronically available member encounters for health plans, improving access and outcomes, saving time and resources, and expediting fulfillment without provider abrasion