Risk Adjustment Coding

Risk Adjustment Coding is an end-to-end risk adjustment and clinical coding solution for payers that need accurate supporting data from member medical records to help drive improved risk scores.


What’s included in Risk Adjustment Coding

  • Risk adjustment coding you can trust

    • We have more than 20 years of experience in medical records retrieval, codding, and abstraction
    • Ensure coding accuracy through clinical staff and quality control measures
    • Scale to suit your needs with onshore and offshore offices
    • Optimize reimbursement with AI and natural language processing coding technology
    • Help accurately identify HCCs that are commonly missed or coded improperly in manual reviews
  • Fully integrated risk adjustment solution

    • Retrieve medical records and perform clinical coding
    • Integrate with Risk Advisor using smart analytics to help improve your score
    • Utilize the same medical records to be abstracted for quality ratings for HEDIS® or Stars™
  • Real-time transparency

    • Stay up to date on the status of the retrieval and coding
    • Use Alert, a client portal that shows the status of chart retrievals in real time
    • Allow payers to manage the process and communicate internally using Alert
    • Portal includes a dashboard, key sites, member view, pends by site, and other key features

Software to help provideaccurate risk adjustment coding

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Innovative technology to help increase review speed

Leverage AI and natural language processing technology to review a broader data set rapidly and thoroughly. This includes clinical evidence within the unstructured narrative of the medical record for better accuracy and more complete documentation.

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A flexible workforce to achieve scalability

Risk Adjustment Coding allows you to engage a flexible workforce in scalable record retrieval through either our onshore or offshore offices.

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Advanced software to help improve accuracy

Help improve accuracy and compliance of revenue with the industry's first end-to-end risk adjustment solution incorporating chart retrieval, analytics, coding, and submission. Risk Adjustment Coding helps you achieve high accuracy rates supported by clinical evidence and our rigorous quality control, helping to minimize audit risks.

Providing Measurable Value

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4+ M

charts coded annually for risk

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100 %

audit pass rate

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coders across our onshore and offshore offices

Our outcomes

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