Risk Adjustment

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A new standard in risk adjustment.

Named the 2021 Best in KLAS Software & Services by KLAS Research, our solution provides reliable analytics and flexible workflow tools to support your program’s important risk adjustment and compliance activities.

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Your complete risk adjustment solution

Apixio’s Risk Adjustment solutions use proven AI algorithms to support a comprehensive retrospective chart review experience for Medicare Advantage, Affordable Care Act, and Medicare Shared Savings programs. Whether you are using our auditing or coding solutions, your risk adjustment team can review more charts more efficiently, ensuring your coding submissions are as complete and accurate as possible.

Complete risk solutions for a more complete population profile.

Apixio’s solutions deliver speed, transparency, and accuracy never thought possible. Instead of reading through hundreds of pages of patient charts, reviewers are pointed to specific pages with either supporting evidence of net-new HCCs missing evidence of an existing code, drastically reducing review times. 

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Risk Adjustment Solutions

HCC Identifier

Apixio's HCC Identifier solution creates an accurate risk score for payment adjustment and care management with the least amount of time and effort. AI algorithms review patient encounter data and identify well-documented conditions unreported in claims data. These conditions are presented in a user-friendly application for expert coders to approve before submission to CMS.

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HCC Auditor

Apixio's HCC Auditor solution ensures that reported risk adjustment diagnoses have the required supporting evidence in linked clinical encounters. AI algorithms review patient encounter data associated with submitted diagnoses and determines if documentation meets audit requirements. Those diagnoses in question are then presented to expert coders in a user-friendly application for review and approval.

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