ProDx – Prospective Diagnosis Review

Capstone is proud to introduce what we believe is the most helpful process available for a PACE organization looking to optimize documentation improvement, compliance, and revenue. Our ProDx prospective review takes advantage of the clinical expertise of RN coders to review clinical documentation for participants and develop a preliminary problem/diagnosis list for providers, prior to performing comprehensive assessments.

The coders review previous encounters, labs, radiology, medication lists, consult reports and proprietary analytics in order to provide a detailed list of all diagnoses and ICD codes along with a rationale for each potential diagnosis. Providers use this list to aid in complete and accurate documentation and coding. ProDx is limited to annual and semi-annual primary care assessments.

Experience with this service model has found it to be highly effective for identifying and documenting commonly missed diagnoses and codes. Pricing is based as per member/per month or per review, and we offer a discount if bundled with other services.