• Request a demo of the AI-driven technology that's changing healthcare

    Ready to see how we're starting the healthcare revolution? Complete the form below and a member of our team will be in touch with you soon about a demo.

  • This field is for validation purposes and should be left unchanged.

Protect your organization from audit risk with AI

Retrospective coding programs have come under increasing scrutiny from CMS and HHS. AI-powered risk adjustment compliance solutions can help your team audit submitted codes efficiently and accurately.

Compliant code submissions. Efficient workflows.

Every coding team prides itself on the accuracy of their work. However, a recent survey found that most risk adjustment teams only have time to QA 10% of coding decisions, and these manual reviews are time consuming, costly, and often done haphazardly at the end of a long coding season. AI can help direct your organization’s compliance efforts and perform audits efficiently so you get the most out of your reviews.

HCC Identifier Streamlined Application Interface

Benefits of AI-powered coding audits

  • Focus. Targeted identification of areas of potential non-compliance.
  • Efficiency. Reduced time to review coding decisions and supporting evidence.
  • Accuracy. More complete evaluation of potential audit risk with less effort.
  • Flexibility. Customized workflows to help organizations focus on what matters most.

Our solutions

HCC Auditor

HCC codes from supplemental data are closely scrutinized for both Medicare Advantage and ACA risk adjustment programs. Apixio’s HCC Auditor solution uses AI algorithms to confirm whether there’s sufficient evidence in patient charts to support submitted HCCs. Reviewers can then evaluate whether required documentation elements are missing and flag unsupported codes for remediation or deletion.

Learn More

Zero Evidence Report

Condition codes are often submitted by physician offices without the necessary supporting evidence for HCC coding, which puts health plans and providers at compliance risk. Apixio’s Zero Evidence Report identifies codes submitted to CMS on claims that lack appropriate evidence in source encounter notes, helping your organization identify areas for physician training and potential code deletes.

Learn More