Precision HCC Coding

Stop the Leakage. Reclaim Your Rightful Revenue.

Inaccurate HCC coding isn't just a compliance risk—it's a financial drain. Our clients don't just survive audits; they thrive. We deliver a 21% average lift in RAF scores while ensuring total audit-proof integrity.

Audit Defense: Optimized
Adept Minds AI Coding Dashboard
Clinical Text Input
Patient presents with persistent fatigue, polyuria, and polydipsia. Blood glucose levels consistently elevated at 280 mg/dL.HbA1c measured 9.2%. Patient reportsdecreased sensation in bilateral lower extremities consistent with peripheral neuropathy. Fundoscopic exam revealsmicroaneurysms and retinal hemorrhages indicating diabetic retinopathy.
HCC Suspects Identified
HCC 19Diabetes with Chronic ComplicationsEvidence: Neuropathy, Retinopathy
HCC 108Vascular DiseaseEvidence: Retinal Hemorrhages, Microvascular Damage
CLINICAL CONFIDENCE98.4%
Est. RAF Lift+0.421
Rev Reclamation$12,400
EPICCERNERALLSCRIPTSATHENAHEALTHECLINICALWORKSNEXTGENMODERNAMAYO CLINIC
EPICCERNERALLSCRIPTSATHENAHEALTHECLINICALWORKSNEXTGENMODERNAMAYO CLINIC

The Anatomy of Down-Coding.

See exactly how Adept Minds catches the hidden complexity that human coders miss under pressure.

Hover to Reveal

The Diabetic Complication Gap

Standard Human Coding

"Physician note reads: 'Patient has Type 2 Diabetes. Complains of tingling and numbness in feet.'"

Coder assigns E11.9 (Diabetes without complications) because 'Neuropathy' wasn't explicitly diagnosed.

REVENUE LEAKAGE

The Diabetic Complication Gap

Adept Minds AI View

AI semantic engine links 'tingling/numbness' to Diabetes. Auto-generates a physician query to confirm Diabetic Neuropathy.

Validated Code Suggested

HCC 18 (Diabetes with Neurologic Complications)

REVENUE RECOVEREDRAF Lift: +0.302
Hover to Reveal

The Unstaged Lab Result Trap

Standard Human Coding

"Routine lab results show an eGFR of 28 mL/min. The physician reviews the labs but doesn't explicitly mention it in the assessment."

Coder ignores the lab value. Chronic Kidney Disease is left unstaged or completely omitted from the claim.

REVENUE LEAKAGE

The Unstaged Lab Result Trap

Adept Minds AI View

AI scans 100% of structured lab data, flags the consecutive eGFR of 28, and prompts the MD to stage CKD at the point of care.

Validated Code Suggested

HCC 137 (Chronic Kidney Disease, Stage 4)

REVENUE RECOVEREDRAF Lift: +0.226
Hover to Reveal

The Historical Recapture Drop

Standard Human Coding

"Patient had Severe Malnutrition documented by a specialist last year. During this year's annual wellness visit, it is forgotten."

The chronic condition drops off the patient's record for the calendar year. The payer assumes the patient is healthier.

REVENUE LEAKAGE

The Historical Recapture Drop

Adept Minds AI View

Retrospective AI engine cross-references 3 years of historical claims, identifies the dropped HCC, and surfaces it for the current encounter.

Validated Code Suggested

HCC 21 (Protein-Calorie Malnutrition)

REVENUE RECOVEREDRAF Lift: +0.713

Two lenses.
One intelligence layer.

Recover what was missed yesterday. Capture everything at the point of care tomorrow. Both on your infrastructure — zero data egress.

Retrospective Review

Our AI and clinical experts audit your historical records to surface every missed HCC code, under-coded condition, and documentation gap. Revenue your team earned but never collected — recovered and returned.

RS RECOVERABLEE11.65 HCC 18
MISSED CODEN18.3 CKD Stage 3
UNDER-CODEDI50.22 HCC 85
Prospective Review

Surface suspect conditions before the encounter. The AI pre-reads the chart so your physician walks in prepared — documentation complete, codes accurate from the first word spoken.

Pre-encounter intelReal-time codingZero rework
0%

RAF Lift

Additional risk score captured vs unassisted human coding

0Cr

Avg Recovery

Per year at a 300-bed hospital on risk-adjusted schemes

0min

Saved Daily

Per physician returned from documentation to patient care

0

Data Egress

Patient data stays on your servers. Every inference is local.

Answering Your Critical Audit Questions.

Proactive identification of documentation gaps is the only way to protect your revenue from payer clawbacks.

How can I prepare for a RAC or Payer Audit without panicking?

We conduct proactive, multi-specialty mock audits using certified HCC coders to identify and correct documentation vulnerabilities before payer scrutiny begins.

Why is my RAF score dropping despite seeing sicker patients?

How do I stop 'down-coding' from reducing my revenue?

How do I keep up with annual ICD-10 and HCC model updates?

Where are my biggest documentation gaps for Risk Adjustment?

Your people know your patients. We help them work faster.

Your people know your patients. We help them work faster. Adept Minds AI handles the paperwork. Your team handles the judgment. That's how it should be.

Book a Demo