Risk Adjustment
Clinical Suite

Achieve complete and accurate risk capture to enhance care quality and outcomes

Identify. Prioritize. Perform.

Complete and accurate risk capture is essential to success in value-based contracts. Effective risk adjustment can improve revenue accuracy, enhance care quality, and reduce compliance and audit risks—but achieving this is often easier said than done. Combing through mountains of clinical data requires time and resources that many provider organizations simply don’t have at their disposal. 

The Risk Adjustment Clinical Suite is a SaaS-based, modular solution that seamlessly integrates with EHRs to augment—not undermine—existing clinical workflows. Using AI-derived insights and our proprietary Natural Language Processing (NLP) engine, the Clinical Suite enables provider organizations to simultaneously achieve complete and accurate risk capture for multiple patient populations. 

Risk Adjustment Clinical Suite Infographic

More effective and accurate risk capture

Easily identify high-risk patients and close documentation gaps for better clinical and financial outcomes.

Clinical Suite Products

Pre-Visit Prep
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Point of Care Suspects
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Post-Visit Review
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Retrospective Review
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Risk Adjustment Clinical Suite: The Key To Value-Based Success

By delivering better satisfaction, better clinical outcomes, and better population health, value-based care can transform healthcare. Effective risk adjustment is essential to success in value-based care—but for many provider organizations, achieving complete and accurate risk capture is easier said than done.

Effective risk adjustment is key to succeeding in value-based care, but many provider organizations are struggling to achieve complete and accurate risk capture. Providers need to be able to uncover and correct risk gaps at every stage of care delivery, not just after claims are submitted.

The Risk Adjustment Clinical Suite from Edifecs leverages AI & NLP to help provider organizations close care gaps, flag risk-adjustable opportunities, and reconcile clinical data with HCC codes—without disrupting clinical workflows.

It’s time to work smarter, not harder.

We help streamline risk adjustment workflows for more accurate and effective risk capture.

Frequently Asked Questions

How much is a properly coded Hierarchical Condition Category (HCC) code worth?

How are RAF scores calculated?

What is the most common reason for improper payment?

News & Insights

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Learn how to assess your own preparedness for VBC arrangements with an infographic that tracks several facets of organizational readiness and shows you.
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Beyond MEAT: The 3 Common Operational Problems in Adopting HCC Coding that Providers Face
Discover ideas to enhance provider adoption and performance in value-based programs.
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Risk Adjustment Clinical Suite: The Key to Value-Based Success
By delivering better satisfaction, better clinical outcomes, and better population health, value-based care can transform healthcare. Effective risk adjustment is essential to success in value-based care—but for many provider organizations, achieving complete and accurate risk capture is easier said than done.
Learn More  ❯
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