Automate Patient Risk Adjustment and HCC coding

This video explains how AI-driven medical coding supports HCC (Hierarchical Condition Category) risk adjustment and RADV (Risk Adjustment Data Validation) audits in value-based care. Timestamps: 00:00 - (Intro) Value-Based Care & Risk Adjustment Fundamentals 10:57 - HCC Coding Workflows & Technology 20:20 - Live Demo: HCC Coding Platform 24:44 - RADV Audits & CMS Requirements 30:44 - Live Demo: RADV Validation Tool Starting from the fundamentals of risk adjustment, the session shows how NLP models analyse clinical documentation to: - Detect under-coded and over-coded conditions - Map diagnoses to ICD-10 and HCC categories - Attach clinical evidence automatically - Support large-scale retrospective reviews - Prepare compliant RADV audit submissions You’ll also see how human reviewers collaborate with AI through an intuitive coding and audit interface. What you’ll learn: - How RAF scores are calculated and why accuracy matters - Common pitfalls in HCC coding - How AI reduces missed conditions and audit risk - RADV audit requirements and CMS validation rules - Scalable workflows for millions of medical records Resources: Risk Adjustment with Martlet AI - https://martlet.ai/ #MedicalCoding #HealthcareAnalytics #HCCCoding #RADV #AIinHealthcare #HealthcareCompliance #ValueBasedCare #ClinicalDocumentation #MedicalNLP