Your Connection to Exceptional Performance
Experts in clinical data acquisition, defensible risk adjustment coding, and HEDIS/quality abstraction
Carey Ketelsen
President
Jay Ahlmer
Executive Vice President
Roger Marcell
Sr. Vice President, Payer Strategy & Success
Virtix Health partners with health plans and provider organizations to support risk adjustment, quality, and value-based care programs through accurate clinical data acquisition, expert coding, and purpose-built technology.
Risk Adjustment
At the core of Virtix Health is a focus on risk adjustment, powered by clinical data acquisition and expert ICD-10 and HCC coding, supported by our HITRUST-certified Linx platform and AI-powered CARAT™ technology. Together these capabilities ensure diagnoses are complete, accurate, and fully supported by the medical record, enabling compliant, audit-ready performance.
HEDIS & Quality Abstraction
We also provide HEDIS and quality abstraction services, as well as support provider risk and value-based care workflows, to help organizations prepare for an increasingly outcomes-driven healthcare environment.
Retrospective. Prospective. Concurrent.
WISeR
In addition, Virtix Health support health plans with payment integrity, prior authorization, and documentation validation services. These capabilities help ensure appropriate payments, support authorization workflows within CMS’ WISeR (Wasteful and Inappropriate Service Reduction) model, and verify the accuracy of clinical records.
Our mission is to reduce administrative burden, improve operational efficiency, and bring clarity and confidence to the clinical documentation and coding that underpin performance across risk adjustment and quality programs, so organizations can focus on delivering patient care.