AI-POWERED RISK ADJUSTMENT

Improve coding accuracy with Advanced Risk Adjustment

With powerful enhancements like the new CDI Agent & AI Copilots, transform fragmented, manual coding processes into seamless, real-time HCC identification that works directly within your EHR workflows.

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Robust Risk Intelligence

The Healthcare Intelligence Cloud enables both providers and payers to improve risk scoring accuracy and achieve better care outcomes.

For Providers

Seamlessly integrate risk adjustment into clinical workflows with point-of-care tools that surface suspected conditions, documentation gaps, and clinical evidence.

For Payers

Transform your risk adjustment performance with AI-powered analytics that drive both prospective and retrospective programs.

Intelligent Risk Capture that Providers Utilize

• Boost RAF Accuracy Up to 20%
  Drive both prospective and retrospective programs through a unified platform that connects data, workflows, and insights. Our solution enables up to 20% improvement in RAF scores while reducing administrative costs and provider abrasion.
• Reduce Missed Conditions
  Leverage advanced algorithms to analyze multiple data sources including EMR data, lab results, health information exchanges, and claims data. Our unified data model creates a comprehensive 360-degree view of each member, ensuring no condition goes unnoticed.
• Improve Documentation Accuracy
  Achieve over 95% accuracy in clinical documentation with built-in compliance checks and concurrent review workflows. Reduce RADV audit exposure by 60% through comprehensive audit trails and documentation evidence.
• Reduce the administrative burden
  Streamline operations with automated worklist generation that prioritizes high-impact cases, highlights dropped conditions, and enables efficient coder-physician communication. Cut documentation time by 30% while improving coding accuracy.

Capture Risk Without Disrupting Care

• Improve Coding Accuracy
  Access real-time insights during patient encounters with instant coding gap notifications and supporting evidence. Direct EMR write-back capability eliminates duplicate documentation while improving coding accuracy.
• Reduce Documentation Burden
  Improve clinical documentation quality through AI-powered suggestions and automated evidence linking. Our platform identifies potential gaps and provides the context needed for accurate condition capture.
• Drive VBC Performance
  Leverage advanced algorithms to analyze multiple data sources including EMR data, lab results, health information exchanges, and claims data. Our unified data model creates a comprehensive 360-degree view of each member, ensuring no condition goes unnoticed.

Why Choose Innovaccer for Risk Adjustment?

Proven Results

Clients see up to 30% improvement in coding accuracy, significant reduction in documentation time, and improve risk score accuracy.

Seamless Integration

Innovaccer integrates directly with all major EHRs, automating data ingestion from multiple sources, normalizing the data, and pushing real-time updates.

AI-Powered Intelligence

Our risk adjustment system leverages advanced natural language processing, predictive analytics for suspect condition identification, and machine learning algorithms for continuous improvement.

Frequently Asked Questions

How does Innovaccer improve coding accuracy?

Our platform analyzes both structured and unstructured data from multiple sources (EMRs, claims, labs, etc.) to identify potential missed conditions with supporting evidence. The system learns from coding patterns and clinical documentation to detect gaps with up to 95% accuracy. This comprehensive analysis ensures more accurate HCC capture while reducing the risk of overcoding or documentation errors.

Can the solution integrate with our existing EMR system?

Yes, our Risk Adjustment solution seamlessly integrates with all major EMR systems including Epic, Oracle Cerner, MEDITECH, and others. We offer bidirectional integration that enables automatic data ingestion and the ability to write back accepted coding gaps directly into your EMR. This integration eliminates duplicate documentation and maintains a single source of truth for clinical information.

How long does implementation typically take?

Implementation timeframes vary based on your organization's size and technical environment, but typically range from 8-12 weeks. Our experienced implementation team handles data integration, workflow configuration, and user training. We use a phased approach to ensure minimal disruption to your operations while achieving quick wins in the first 30 days.

How does the solution support RADV audit preparation?

Our platform maintains comprehensive audit trails and documentation evidence for all coding decisions. The concurrent review workflow ensures proper validation before claims submission, while our AI engine flags potential documentation gaps or inconsistencies. This proactive approach typically reduces audit exposure by over 60% and significantly improves audit outcomes.