Get To Know Our Services
We provide healthcare consulting services that help physician practices improve quality performance, optimize risk adjustment, strengthen care management workflows, and reduce avoidable utilization. Our healthcare consulting services focused on practice transformation, quality improvement, risk adjustment, and high-utilizer management.
Our approach is rooted in structured care management, proactive gap closure, workflow alignment, coding accuracy, utilization reduction, and value-based performance improvement.
We help practices connect operations, care teams, and performance strategy to support stronger quality outcomes and more sustainable financial results.
Practice Transformation & Quality Improvement
We help practices redesign care delivery and operational workflows to improve performance on priority quality measures and strengthen value-based care execution.
Our work includes improvement strategies for cancer screenings, diabetes management, blood pressure control, behavioral health follow-up, medication management, and preventive care access.
Risk Adjustment & Coding Optimization
Services may include:
HEDIS performance improvement strategy focused on closing gaps across preventive, chronic, and behavioral health domains.
Care gap closure workflow design, including EHR-integrated alerts, quarterly outreach campaigns, and standing order protocols for labs and screenings.
Annual Wellness Visit campaign planning and execution to increase visit completion and support multiple quality and chronic care measures.
Care team role optimization, including MA pre-rooming checklists, RN care manager support for complex patients, and quality improvement coordination.
Behavioral health integration support, including same-day warm handoffs and follow-up processes aligned to FUH and FUI measures.
Population health technology optimization, including registry management integration, gap alert configuration, and use of payer supplemental data feeds.
We support practices in improving the accuracy of risk capture through structured HCC coding, prospective review, retrospective auditing, and provider education.
Services may include:
Risk stratification and panel segmentation using a four-tier model of Critical, Complex, Moderate, and Low-risk patients.
Prospective HCC chart review for higher-risk patients to identify and close coding opportunities.
Provider coding education focused on hierarchy-aware documentation and commonly missed HCC categories such as diabetes complications, CKD staging, CHF specificity, BMI, depression, and morbid obesity.
AWV-based risk capture support, using the annual wellness visit as a high-yield touchpoint for HCC suspect review.
Retrospective coding audits comparing claims and EHR documentation to identify missed risk adjustment opportunities.
Provider-level RAF trend reporting to support ongoing monitoring and accountability.
Complex Care & High-Utilizer Management
We help practices build programs for the patients who drive the highest utilization and need the most coordinated support.
Our model is centered on identifying the top utilizers, assigning dedicated coordination resources, and implementing timely follow-up after emergency department or inpatient events.
Risk Adjustment & Coding Optimization
Services may include:
High-utilizer intensive care management with individualized care plans and structured follow-up.
Post-ED and inpatient outreach workflows, including contact within 48 hours for high utilizers.
Transitional Care Management support for discharged patients, including outreach within 2 business days and 7-day/14-day follow-up workflows.
Chronic Care Management enrollment optimization for eligible high-risk patients.
Social determinants of health screening and community referral workflows for complex patient populations.
Readmission and avoidable ED reduction efforts linked to operational care management processes.
Our services are designed to help practices improve the operational and financial performance measures tied to payer contracts and value-based reimbursement.
Our framework connects these initiatives to Star Rating improvement, quality withhold recovery, risk adjustment revenue uplift, billable CCM/AWV/TCM services, and avoidable utilization savings.
Services may include:
Star Rating performance improvement support tied to HEDIS and operational execution.
Quality KPI and operational KPI tracking, including HEDIS composite performance, AWV completion, CCM enrollment, and gap closure rates.
Risk and utilization KPI reporting, including RAF score, readmission rate, ED visits per 1,000, and HCC audit completion.
Program ROI modeling and financial impact planning using practice-specific data inputs for final projections.
Why Nelangie Cares?
Our plans and workflows are built around measurable goals such as reaching the goal on targeted measures, increasing Annual Wellness Visit completion, improving CCM enrollment, raising RAF score accuracy, reducing readmissions, reducing avoidable ED visits, and strengthening documentation and audit completion rates.
They also link clinical and operational improvement to financial outcomes, including bonus uplift, quality withhold return, risk adjustment revenue opportunity, care management billing, and utilization savings.
A re You Ready To Transform Care Delivery?
Let’s build a strategy for better outcomes, stronger workflows, and improved value-based performance.