MedRecPros Consulting
Client results

Real Outcomes for California Healthcare Organizations

From HEDIS data validation to full compliance program builds, here's how MedRecPros Consulting — in partnership with ProEd Consulting — has helped Medical Groups, IPAs, and MSOs across California.

35+

Years of combined experience

100+

Organizations served

State and Federal healthcare regulatory standards

CA

California-based & focused

Compliance
HEDIS ValidationHCC CaptureProvider EducationCoding & Auditing

California IPA — Inland Empire

Challenge

A California IPA operating several medical clinics throughout the Inland Empire needed to improve HEDIS data validation accuracy and HCC capture rates. Documentation gaps across clinic sites were resulting in missed risk adjustment opportunities and incomplete quality reporting.

Solution

In partnership with ProEd Consulting, MedRecPros conducted comprehensive HEDIS data validation and HCC capture initiatives across all clinic locations. Provider and staff education was delivered to improve documentation practices and ensure missing HCC opportunities were identified and captured prospectively.

Results

HEDIS & HCC

Focus area

Multi-clinic IPA

Scope

Improved documentation & HCC capture

Outcome

Revenue
HEDIS ValidationHCC CaptureProvider EducationMSO Consulting

MSO — Long Beach, CA (San Diego & Los Angeles County Network)

Challenge

A Long Beach-based MSO supporting multiple IPAs across San Diego and Los Angeles County — with a combined population of 75,000 — needed HEDIS data validation, HCC capture improvement, and documentation enhancement across its entire delegated network.

Solution

In partnership with ProEd Consulting, MedRecPros delivered HEDIS data validation and HCC capture services across the full IPA network. A comprehensive provider and staff training and education program was implemented to sustain documentation improvements across all participating organizations.

Results

75,000

Combined member population

San Diego & LA County

Coverage area

HEDIS, HCC & Training

Services delivered

Operations
HCC CaptureHEDIS ValidationMedical Records ScanningProvider EducationCoding & Auditing

IPA — Los Angeles, CA

Challenge

A Los Angeles IPA with a member population of 25,000 operated a large, busy Medical Group spanning pediatrics, Medicare Advantage, Medi-Cal, OB/GYN, Family PACT, BCDCP, and other state programs as an ACA Medical Group. The organization needed end-to-end support across coding, records, compliance, and education.

Solution

MedRecPros created custom forms and scanned medical records to enable coders to abstract missed HCC opportunities. HEDIS data validation was performed across all programs, and coding was completed for all state programs based on available documentation. A full provider and staff training and education program was delivered across the organization.

Results

25,000

Member population served

Medicare, Medi-Cal, ACA & more

Programs covered

HCC, HEDIS, Coding & Training

Services

Compliance
OIG ComplianceHCC CaptureHEDIS ValidationBilling PolicyCompliance Advisory

IPA — Imperial Valley, CA

Challenge

An Imperial Valley IPA operating Rural and FQHC clinics with ACA certification needed to strengthen its compliance infrastructure, improve documentation, and establish standardized policies and procedures across its diverse clinic network.

Solution

MedRecPros created tailored policies and procedures based on the organization's specific type and structure, improved documentation practices, and captured HCC and HEDIS data validation opportunities. A comprehensive Compliance Plan was developed for the entire organization, with workflows redesigned to improve operational efficiency across all clinic sites.

Results

Org-wide

Compliance plan scope

Rural & FQHC

Clinic types served

Policies, HCC & HEDIS

Deliverables

Operations
Medical Records ScanningCompliance AdvisoryProvider EducationCorporate Consulting

Multi-Client Medical Records & Corporate Consulting Engagement

Challenge

Multiple client organizations needed large-scale medical records digitization to prepare for coding and auditing workflows, alongside ongoing corporate consulting, compliance advisory support, and case-by-case compliance investigations.

Solution

In partnership with ProEd Consulting, MedRecPros scanned thousands of medical records and uploaded them to each client's database, making records immediately accessible for coding and auditing teams. Provider and staff training and education were delivered across engagements, complemented by Compliance Advisory services and individualized case-by-case investigation support.

Results

Thousands

Records scanned & uploaded

Corporate & case-by-case

Support model

Scanning, Training & Advisory

Services

What Our Clients Say

MedRecPros didn't just hand us a report — they stayed with us through implementation. Our compliance program is stronger than it's ever been.

Chief Compliance Officer

California IPA — Inland Empire

The HEDIS validation and HCC capture work made an immediate impact across our entire network. The training program gave our providers the tools to sustain it.

Chief Medical Officer

MSO — Long Beach, CA

From scanning records to building our compliance plan, MedRecPros handled everything. They understood our programs and our patients.

Medical Director

IPA — Los Angeles, CA

Ready to See Results Like These?

Every engagement starts with a free consultation. Tell us about your organization's challenges and we'll outline a path forward.