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Risk Adjustment

RCM Solutions for
Medicare Advantage Plans

Medicare Advantage plans that accurately document member risk scores receive significantly higher CMS payments. VLMS Software’s HCC and RAF tools quantify your documentation gap and drive systematic closure.

97.2%Avg Net Collection Rate
<5%Target Denial Rate
90 DaysAvg Time to Improvement
500+Organisations Served

Built for the Complexity of Medicare Advantage Plans

Medicare Advantage plans that accurately document member risk scores receive significantly higher CMS payments. VLMS Software’s HCC and RAF tools quantify your documentation gap and drive systematic closure. Our team combines deep domain expertise with purpose-built diagnostic tools to give you an accurate picture of where revenue is leaking — and a managed services operation to close those gaps.

Every engagement starts with a comprehensive revenue leak audit across your key performance dimensions: net collection rate, AR days, denial rate, clean claim rate, cost to collect, and coding accuracy. We benchmark against your specialty and segment peers, identify the highest-value gaps, and deliver a prioritised action plan within 48 hours.

  • AAPC/AHIMA certified coders with specialty-specific expertise
  • Real-time eligibility verification and prior auth management
  • Denial management with tracked appeal success rates
  • Monthly performance reporting against MGMA/HFMA benchmarks
  • Performance-based pricing — we earn when you collect
Performance Dashboard
Net Collection Rate
97.2%↑ improvement
Days in AR
34.5↓ reduced
Denial Rate
4.6%↓ reduced

Start With a Free Diagnostic

Use any of our 25 free RCM tools to benchmark your performance right now — no account required.

Let's Optimise Your Revenue Cycle

Our specialists in Medicare Advantage Plans RCM are ready to assess your current performance and build a roadmap to top-quartile results.