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Practice

Caredatum Risk Assurance

A true and fair view of your risk position, across every contract you hold rather than the one somebody else manages.

01 What we establish

Four dimensions, one instrument, one panel.

Risk Assurance applies Truescore to a book of members. The output is a position, not a report: what your performance is, what the record supports, and what specifically would change it.

Condition accuracy

Which conditions the record supports, which are carried without support, and which are present in the clinical picture but absent from the coding. Each finding arrives with the documentation it would take to stand it up, and with what was submitted for that member last year.

Open quality measures

Which measures are open on which members, the specific action that closes each one, and what was done for that member in the prior year. A measure you closed last year and lost this year is a different problem from one you have never closed.

Utilization the panel is absorbing

Emergency department and admission patterns, medications initiated by specialists that the accountable physician has not seen, and brand dispensing where a generic equivalent exists.

Capacity to do the work

Access, scheduling, fill rate and panel capacity. Whether the practice can physically deliver what the first three dimensions identify, and where it cannot, that becomes the finding rather than a longer list nobody can work.

02 The provider view

One page. Carried into the room.

Everything above resolves to a single page per provider, prepared before the visit. It is built on one rule: if a data element does not change what happens in that visit, it does not belong on the page.

Everything the office staff and the provider need when they are face to face with the member.

Your staff does the work. Your physicians do not.

The scheduler, the medical assistant, the office manager and the administrative team work in Caredatum. The physician receives the prepared page and does the part only a physician can do. We are not competing for two inches of a clinician's screen, and we are not asking anyone to log into a second system during a visit.

03 Verification

Nobody grades their own homework.

A finding is not closed because somebody said it was. It is closed when the encounter, the code and the claim show that it was, and the position is restated against that evidence on the next cycle.

Reported closure against evidenced closure Two bars. The upper, drawn as an outline, is closure as reported in a status field. The lower, drawn solid, is closure the encounter, code and claim actually support. The distance between them is reported as a finding in its own right rather than averaged away. Reported closed what the status field says Evidenced closed what the record supports Reported as its own finding
Schematic. The bar lengths carry no measurement — only the direction of the claim, which is that reported closure runs ahead of evidenced closure until somebody checks.

The operational half is not only for risk

The fourth dimension, access and scheduling and fill rate and capacity, is scored the same way whether a practice is paid fee-for-service or under a risk arrangement. A fee-for-service group gets the operational work in the same login as everything else, and simply carries fewer findings in the first three dimensions. We do not run a separate product for it.

What this rules out

It rules out the most common failure in this market: a closure rate that measures how diligently a team updated a status field. If the data does not carry it, we do not count it, and the difference between what was reported closed and what the record shows closed is itself one of the more useful numbers we return.

Next step

Start with a baseline.

If you already work with an enablement partner, none of this displaces them. What it adds is a view of every contract you hold rather than the one they manage, established to a standard you can put in front of somebody who does not want to believe it.

Give us one period of data from the contracts you already hold. We return your position across all four dimensions, the evidence behind every finding, and the specific work that would move it. You decide what happens after that, not before.