Real-Time HCC Identification
Detect and validate HCC-relevant conditions while providers are still charting or before claim closure.
Our concurrent review teams perform structured HCC validation, documentation checks, coding review, and clinical condition assessment during or immediately after patient encounters — ensuring diagnoses are captured before claims close.
Detect and validate HCC-relevant conditions while providers are still charting or before claim closure.
Evaluate whether medical records meet compliance requirements for risk-adjustable conditions.
Review diagnosis codes, reduce unsupported conditions, and avoid downstream correction cycles.
Identify missing assessments, follow-up needs, or chronic conditions lacking documentation.
Deliver concise summaries to help clinicians improve documentation quality and accuracy.
Ensure all risk-impacting diagnoses are validated before claim submission to prevent revenue loss.
Receive clinical notes, charts, vitals, and encounter records in near real time.
Cross-check documented conditions with clinical indicators and history.
Apply appropriate HCC models and validate support for risk-adjustable codes.
Identify missing elements needed to support diagnoses (MEAT/TAMPER).
Provide structured feedback to clinicians for documentation improvement.
Mark encounters as complete and validated for downstream claim submission.