Risk Adjustment Coding

An end-to-end risk adjustment and clinical coding solution for payers that need accurate supporting data from member medical records to help drive improved risk scores.

Accurate Medical Record Coding

Engage flexible workforce in scalable record retrieval through either our U.S. offices in Georgia and Kentucky or our offshore offices

Leverage Health Fidelity's natural language processing technology to rapidly and thoroughly review a broader data set, including clinical evidence within the unstructured narrative of the medical record, for better accuracy and more complete documentation.

Achieve high accuracy rates supported by clinical evidence and our rigorous quality control, minimizing the risk of audit

Improve accuracy and compliance of revenue with the industry's first end-to-end risk adjustment solution incorporating chart retrieval, analytics, coding, and submission

Change Healthcare and Health Fidelity Partner to Increase Quality and Accuracy of Risk Adjustment Coding

Combined approach to provide health plans with an end-to-end risk adjustment solution for superior performance

How Artificial Intelligence Can Transform Risk Adjustment

To receive funding for serving high-risk patient populations, payers must prove their population risk scores.

Trust, Accuracy, and Transparency

Risk adjustment coding expertise you can trust

  • Partner with experts who have more than 20 years of experience in medical records retrieval, coding, and abstraction. 
  • Ensure coding accuracy through our clinical staff and quality control measures. With both onshore and offshore offices, we can scale to suit your needs.
  • Optimize reimbursement with Health Fidelity’s natural language processing coding technology to accurately identify HCCs that are commonly missed or coded improperly in manual reviews.

Fully integrated risk adjustment solution

  • Retrieve medical records, perform clinical coding, and integrate with Risk Advisor using smart analytics to help improve your risk score.
  • Utilize the same medical records to be abstracted for quality ratings for HEDIS® or Stars™.

Real-time transparency

  • Stay up to date on the status of the retrieval and coding through Alert, the client portal that shows the status of chart retrievals in real time. 
  • Allow payers to manage the process and communicate internally using the Alert portal’s dashboard, key sites, member view, pends by site, and other features.

Providing Measurable Value

charts coded annually for risk
audit pass rate
US FTE, 250 Manila FTE, 1,500 remotes

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