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Protect your risk adjustment program with AI compliance analytics

The majority of your organization’s total RAF score is coded by physician offices on claims—but not every code has appropriate supporting evidence. AI can help you thoroughly and quickly assess where you’re missing evidence for submitted condition codes to mitigate audit risk.

Zero Evidence Report: The simplest way to find and fix unsupported code submissions

Condition codes are often submitted from a physician office without the necessary supporting evidence, which puts health plans and providers at compliance risk. Apixio’s Zero Evidence Report identifies codes submitted to CMS and HHS on claims without necessary supporting evidence in the source encounter note to inform documentation improvements and code deletions.

Laptop showing Apixio's Zero Evidence Report

Benefits of AI-powered compliance

  • Efficient auditing. Reduce chart audit times by 85% with a targeted list of codes to review.
  • Assessment of high-risk codes. Rigorously assess which submitted codes may require additional support or need to be deleted.
  • Targeted data for provider education. Identify providers who need documentation training and coaching to improve HCC capture on claims
Ensure accurate coding submissions with AI analytics