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Clinical Documentation Improvement

Our Clinical Documentation Improvement (CDI) services involve a dedicated team of CDI specialists who collaborate directly with healthcare providers to enhance the accuracy and completeness of clinical notes. Our specialists focus on ensuring that clinical documentation is thorough, precise, and fully codable, reflecting the true acuity of patients and the resource utilization required for their care. By working closely with physicians and other clinicians, we help ensure that all diagnoses, procedures, and treatment plans are accurately documented, reducing the risk of coding errors and misreporting. This process not only supports appropriate reimbursement but also strengthens compliance with regulatory standards and ensures better representation of patient care complexity. Ultimately, our CDI services help improve clinical outcomes, optimize reimbursement, and position healthcare providers for success in value-based care models.

Planning and sketching

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Team working

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Flowchart and wireframe

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User experience Testing

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ACA Commercial Risk Adjustment Coding

We support accurate and compliant risk adjustment coding for Affordable Care Act (ACA) exchange-based plans by capturing all eligible diagnoses that impact a member’s Risk Adjustment Factor (RAF) score. Our certified coders conduct thorough medical record reviews and detailed abstraction to identify and document all relevant chronic and high-impact conditions. By aligning with HHS-HCC risk models and payer-specific requirements, we help health plans enhance RAF scores, ensure appropriate premium transfers, and maintain compliance with regulatory standards—ultimately supporting both financial performance and care quality.