Overview of Software Solution for Health Plans

Overview of
HCC Validation Software

Our SaaS Risk Adjustment Platform, driven by GapAI™, stands out for its unique ability to autonomously identify and prioritize HCC opportunities, leading to enhanced revenue capture with unmatched precision and efficiency. What sets us apart is our innovative approach to ingesting and analyzing clinical data from diverse sources, structured and unstructured alike, while pioneering proactive suspecting strategies to maximize risk capture. Experience a new standard of excellence in risk adjustment, where revenue potential is not just a goal but a guaranteed achievement.

Key workflow actions
  • Analyze: Use GapAI™ to bridge care gaps, highlight risk-adjustment opportunities, and align data with HCC codes.

  • Prioritize: Utilize GapAI™ to streamline risk-adjusted chart reviews, focusing on what matters: delivering exceptional patient care.

  • Perform: Empower your risk-adjusted CDI teams with intuitive “agree” and “disagree” workflows to optimize RAF scores, yielding 5 – 10X returns.

Primary Results for Health Plans

Key Results of
HCC Validation Software

Empower health plans with GapAI™ to boost productivity, automate chase lists, and uncover HCC opportunities compliantly, revolutionizing risk adjustment processes for unparalleled efficiency and precision.

400%

Improved
Productivity

27%

Increased
HCC capture

1

Added HCC
per 5.5 chart reviews
Key Benefits for Health Plans

Key Benefits of
HCC Validation Software

Our SaaS platform with GapAI™ automates HCC recommendations, driving significant RAF score improvements and efficiency gains for health plan teams.

Optimal
Revenue Capture

Uncover supported HCC codes using GapAI-enabled diagnosis suggestions

Efficient
Workflows

Increase productivity by 400% through AI-driven case prioritization & automation

Flexible, Scalable Technology

Integrate EMR data seamlessly into existing workflows with scalable tools

Enhanced
Compliance

Ensure regulatory compliance with GapAI™-powered coding validation

AI Technology for Health Plans

Built-in Intelligence for
HCC Validation Software

Leveraging GapAI™ technology, our SaaS platform integrates sophisticated intelligence. It ingests and analyzes clinical data from structured and unstructured sources, employing advanced Natural Language Processing (NLP) for effective unstructured data comprehension. This dual capability enables automatic recommendations to cover gaps in HCC misses, leading to improved RAF scores and enhanced revenue capture, ultimately benefiting patient outcomes.