Efficient, Reliable Risk Adjustment Coding Audits
Risk adjustment programs have come under increased scrutiny from regulators in recent years. Plans and providers must defend the accuracy of submitted HCC codes during RADV and other audits. However, it’s almost impossible to perform thorough audits manually given the tight submission and review timelines for MA and ACA programs.
Apixio’s HCC Auditor streamlines the code review process with the industry-leading AI coding platform that identifies source encounter notes for submitted HCCs. This approach helps audit reviewers focus their efforts on investigating the subset of codes that are most likely to be unsupported.
The HCC Auditor Advantage
MINIMIZE AUDIT RISK FOR YOUR PROGRAM
Ensure 1st-pass coders are making defensible coding decisions with comprehensive audits.
ACCELERATE THE HCC AUDIT PROCESS
Reduce your audit workload by 80% and focus reviews on charts with predicted at-risk HCCs.
SUPPORT IN-YEAR HCC IMPROVEMENTS
Drive in-year coding & documentation improvements with faster, more accurate audit results.
- AI-powered evidence location for reported codes
- Targeted review workflows for potentially unsupported codes
- Clear audit trail of chart reviews and results
- Auditor progress, productivity, and accuracy tracking
- Vendor coding accuracy audits with Apixio Vendor Scorecard