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Unlock Hidden Risk. Strengthen RAF. Secure Revenue.

Risk Adjustment Optimisation performs a comprehensive audit of your entire member or patient population — reviewing EHRs, clinical documentation, HCC coding, and care intensity. We uncover missed risk, validate it, and help you recover what was always there.

Documentation Analysis HCC Gap Mapping CDI Programs Population Reporting RPA-Assisted Review Payer Readiness

Full-Service Delivery

Clinical Documentation Analysis

Deep review of EHRs, encounter notes, treatment history, and care intensity to detect unreported or under-documented chronic conditions.

HCC Gap Mapping & Remediation

Compare recorded diagnoses vs. potential HCC-relevant conditions to find missing codes and documentation gaps.

Clinical Documentation Improvement

Guidance, templates, and physician education to improve initial documentation quality and support coding accuracy.

Population-Risk Reporting & Analytics

Actionable population-level reports on risk distribution, missing conditions, and revenue-impact opportunities.

RPA-Assisted Risk Capture

Automation to scan charts and detect potential undocumented conditions, reducing manual workload and human error.

Contract & Payer Readiness Insight

Data-driven insight to support payer negotiations, risk pool audits, and documentation compliance for capitated contracts.

A Structured Workflow

01

Data Ingestion

Gather full EHRs, encounter records, lab/imaging, treatment history, and claims data across population.

02

HCC Analysis

Analyse records for potential unreported conditions that meet HCC criteria but are undocumented or miscoded.

03

Documentation Review

Evaluate notes for clinical support, MEAT/TAMPER compliance, and completeness for risk validation.

04

CDI Feedback

Provide structured feedback, documentation templates, and clinician education to remedy gaps.

05

RPA Assist

Run bots to detect potential missed conditions and flag charts for human review.

06

Reporting

Produce reports showing recovered risk, revenue uplift potential, and compliance readiness.

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Continuous Cycles

Set up regular audits, documentation reviews, and risk-capture cycles for continuous optimisation.

Ready to work with Valiant Lifecare?

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