Problem lists and documentation

Align clinical documentation with stronger financial performance with IMO Core

IMO Health’s terminology and patient documentation solutions streamline clinical workflows to help clinicians document with greater specificity, manage problem lists more effectively, and uncover revenue opportunities for better clinical and financial outcomes.

Improvement in visit diagnosis specificity with robust clinical terminology

Increase in risk adjustment factor (RAF) scores for optimized reimbursement

Reduction in denied claims via in-workflow prompts flagging unspecified diagnoses

Increase in Medicare Advantage (MA) reimbursement in 6 months

Challenges

Complicated EHR workflows can impede patient data quality

The clinical workflows designed to document and manage clinical patient data can be disjointed and unnecessarily complex, inhibiting providers from delivering the best possible care.

These workflow challenges also affect data quality, with real downstream impacts on billing, reimbursement, quality reporting, and population health initiatives.

HOW WE HELP

IMO Core

IMO Core simplifies documentation and problem list management and provides access to expansive terminologies better insights to patient problems and misclassified diagnoses. This helps ensure high quality data, lessen the clinician HIT burden, reduce denials, and optimize reimbursements.

Minimize disruption to clinical and financial work streams

Document with ease and specificity

Pre-bill coding prompts for errors like non-primary problems documented in the primary position, unspecified laterality, and Excludes1 notes
Flags unaddressed HCCs that impact yearly risk scores and reimbursement

Make problem lists more meaningful

Organizes and categorizes 99.9% of terms in problem lists
Contextualizes medication and lab results for 97% of problems
Cleans duplicate, outdated, and redundant problem list data

Capture accurate, detailed coding behind the scenes

Provides comprehensive clinical terminology mapped to all major global coding systems
Updated 5x per year to ensure compliance with regulatory standards

Improve patient outcomes through smarter, data-driven insights

Quickly identify HCCs from past encounters
Use IMO Clinical AI to extract relevant data from unstructured clinical notes
Aggregate insights from multiple health plans in one view

IMO Core capabilities vary based on EHR channel and integrations

Features

Comprehensive clinical terminology

Covers all possible ways to describe patient problems, including synonyms, misspellings, acronyms, and local vernacular connected through unique IMO Health lexicals that map to all appropriate billing codes
Includes*:
- ICD-9-CM
- ICD-10-CM
- SNOMED CT® US Edition
- CMS HCC & RxHCC
- SNODENT
- DSM-5-TR® & DC: 0-5
- PDPM
- PDGM
- ICD-O-3
- Mondo/OMIM

*IMO Core capabilities vary based on EHR channel and integrations
SNOMED and SNOMED CT® are registered trademarks of SNOMED International. DSM® is a registered trademark of the American Psychiatric Association, and are used with permission herein.

Clinician-friendly diagnosis search and capture

Simple, easy-to-use search that prompts for required specificity

Clinician-focused problem lists

Cleans, organizes, and enhances problem lists with relevant medications and labs
Highlights HCCs and chronic conditions
Delivers greater insights from problems missing from the problem list
Ensures that relevant patient data from across the patient record is visible in the chart
Proactively flags unspecified or misclassified diagnoses at the point of care

Actionable insights supporting risk adjustment

Surface gap-in-care notifications from prior encounters, clinical notes, and payer partners – directly in the problem list
Capture clinicians’ responses, reducing post-visit documentation rework
By accepting 5% of HCC insights, providers can see at least $300K in Medicare reimbursement*

*Projected reimbursement based on initial 1-month usage data

Seamless integration with native EHR workflows

Available via custom EHR integrations, APIs, content files, and FHIR application
Regular terminology release updates

Better coding accuracy for fewer denials

In-workflow alerts that flag common coding errors: unspecified codes, non-primary codes, and Excludes1 rule violations
Rule-based alerts for precise notifications either in provider or coder work queue

Unlock real time, on-demand HCC insights

Measure provider adoption and financial impact with HL7- powered, on-demand HCC capture analytics via IMO Studio*

*Available with select IMO Health integrations

Provider organizations can expect a 10X ROI through reduced denials, rework, and write-offs when they leverage IMO Core.

IMO Core will be a valuable tool in continuing to debulk the patient chart, allowing for a more accurate and cleaner view of the patient's condition.

Dr. Jennie Luna

Scripps Health

The numbers don't lie. IMO Health solutions can bring your organization measurable value by helping to:

Optimize reimbursement
Minimize denied claims
Reduce the HIT burden on clinicians

Latest Resources

Case study: Achieving 80% cleaner problem lists for a more patient-centered record

Learn how Frederick Health dramatically decreased problem list clutter and improved accuracy with IMO Core, enhancing provider trust and patient care.

RADVs and HCCs: Are you ready for audit acceleration?

Payers, providers, and payviders all share in the risks and responsibilities of expanding RADV audits. Is your organization ready for what’s next?

Why every hospital needs a modern tool to manage its surgical dictionary

Running a surgical department costs millions of dollars per year. Advanced tools can boost financial performance, operational efficiency, and clinical care.

POINT OF CARE WORKFLOW

DATA QUALITY MANAGEMENT

PROBLEMS WE SOLVE