Accura
Accurate Risk Adjustment Coding That Reflects the Real Complexity of Patient Care
Scaling Coding Intelligence → 98%+ Accuracy at $2.50/Chart
The result is measurable and consistent:
AI Enabled Risk Adjustment &
Workflow Management Platform
98%+ Accuracy & Completeness
$2.5 Price per chart (audit built in)
Accura
Accurate Risk Adjustment Coding That Reflects the Real Complexity of Patient Care
Scaling Coding Intelligence → 98%+ Accuracy at $2.50/Chart
The result is measurable and consistent:
AI Enabled Risk Adjustment &
Workflow Management Platform
98%+ Accuracy & Completeness
$2.5 Price per chart (audit built in)
Performance That Drives Accurate Risk Outcomes
Scale that Supports Compliance and Growth
Supporting health plans & provider organizations
Our Risk Adjustment Services & Coding Process
Accurate HCC Coding Built on Clinical Understanding and Compliance
- HCC coding and validation
- Prospective chart reviews
- Concurrent risk adjustment support
- Retrospective chart reviews
- Documentation gap identification
- RAF score accuracy support
- CMS-aligned coding review
- Risk adjustment audit preparation support
HCC coding & validation
Prospective chart reviews
Concurrent risk adjustment support
Retrospective chart reviews
Documentation gap identification
RAF score accuracy support
CMS-aligned coding review
Risk adjustment audit preparation support
HCC coding & validation
Prospective chart reviews
Concurrent risk adjustment support
Retrospective chart reviews
Documentation gap identification
RAF score accuracy support
CMS-aligned coding review
Risk adjustment audit preparation support
Our Risk Adjustment Services & Coding Process
Accurate HCC Coding Built on Clinical Understanding and Compliance
Risk adjustment programs depend on precise diagnosis capture and strong clinical documentation. Each reported condition must be supported by clear medical records and aligned with CMS guidelines.
Accura RCM provides detailed chart review services to ensure risk scores accurately reflect patient health status while maintaining full regulatory alignment.
Our coding professionals combine clinical knowledge, structured workflows, and industry-standard coding platforms to deliver consistent and compliant results across large chart volumes.
- HCC coding and validation
- Prospective chart reviews
- Concurrent risk adjustment support
- Retrospective chart reviews
- Documentation gap identification
- RAF score accuracy support
- CMS-aligned coding review
- Risk adjustment audit preparation support
Technology-Enabled risk adjustment solutions
Intelligent Software That Enhances Coding Accuracy and Speed
Accura RCM combines certified coding expertise with intelligent software solutions designed to enhance risk adjustment accuracy, streamline chart reviews, and improve operational efficiency.
Healthcare organizations generate large volumes of clinical documentation in unstructured formats such as physician notes, discharge summaries, medical reports, and EHR records. Manually reviewing these records can be time-consuming and operationally challenging.
Accura RCM supports healthcare organizations with NLP-driven and technology-enabled risk adjustment solutions that help transform clinical documentation into structured, code-ready insights while maintaining compliance and accuracy.
Our approach combines advanced software with human coding expertise to ensure reliable and scalable risk adjustment workflows.
A Structured and Compliant Chart Review Framework
A Structured and Compliant Chart Review Framework
Accura RCM follows a systematic review process designed to ensure clinical accuracy, documentation integrity, and regulatory compliance.
Prospective Reviews
Concurrent Reviews
Retrospective Reviews
Documentation Integrity Review
Comprehensive Audit Review
Prospective Reviews
Concurrent Reviews
Retrospective Reviews
Documentation Integrity Review
Comprehensive Audit Review
How our technology supports risk adjustment
The system analyzes physician notes, discharge summaries, and medical records to identify relevant clinical concepts, diagnoses, and conditions that may impact risk adjustment coding.
NLP technology converts unstructured clinical text into structured and meaningful data that supports coding accuracy and workflow efficiency.
The platform assists in identifying potential HCCs and ICD-related diagnoses from clinical documentation, helping coding teams focus on validation and compliance.
This reduces manual review time while improving consistency and accuracy across high chart volumes. AI-powered coding tools can analyze clinical data and match diagnoses to standardized codes, improving coding precision and reducing errors.
Software tools help prioritize charts based on documentation complexity, risk level, and potential HCC impact.
This ensures coding teams focus on high-value and high-risk cases first, improving productivity and turnaround time.
The system links diagnoses with supporting clinical documentation to ensure coding decisions are backed by clear medical evidence.
This strengthens compliance and audit readiness while maintaining documentation integrity. Clinical NLP systems can interpret context, extract relevant medical entities, and structure documentation for accurate coding and reporting.
Technology integrates with EHR platforms, coding environments, and secure chart exchange systems to streamline operations and improve collaboration between coders and healthcare organizations.
NLP tools help extract and organize information across multiple systems and formats, improving efficiency and data accessibility.
Dashboards and reporting tools help track:
- chart volumes
- coding accuracy
- HCC capture trends
- productivity metrics
- operational performance
This helps organizations monitor and optimize risk adjustment operations.
Intelligent Software That Enhances Coding Accuracy and Speed
Technology-Enabled Risk Adjustment Solutions
Accura RCM combines certified coding expertise with intelligent software solutions designed to enhance risk adjustment accuracy, streamline chart reviews, and improve operational efficiency.
Healthcare organizations generate large volumes of clinical documentation in unstructured formats such as physician notes, discharge summaries, medical reports, and EHR records. Manually reviewing these records can be time-consuming and operationally challenging.
Accura RCM supports healthcare organizations with NLP-driven and technology-enabled risk adjustment solutions that help transform clinical documentation into structured, code-ready insights while maintaining compliance and accuracy.
Our approach combines advanced software with human coding expertise to ensure reliable and scalable risk adjustment workflows.
How Our Technology Supports Risk Adjustment
Technology Capabilities
The system analyzes physician notes, discharge summaries, and medical records to identify relevant clinical concepts, diagnoses, and conditions that may impact risk adjustment coding.
NLP technology converts unstructured clinical text into structured and meaningful data that supports coding accuracy and workflow efficiency.
The platform assists in identifying potential HCCs and ICD-related diagnoses from clinical documentation, helping coding teams focus on validation and compliance.
This reduces manual review time while improving consistency and accuracy across high chart volumes. AI-powered coding tools can analyze clinical data and match diagnoses to standardized codes, improving coding precision and reducing errors.
Software tools help prioritize charts based on documentation complexity, risk level, and potential HCC impact.
This ensures coding teams focus on high-value and high-risk cases first, improving productivity and turnaround time.
The system links diagnoses with supporting clinical documentation to ensure coding decisions are backed by clear medical evidence.
This strengthens compliance and audit readiness while maintaining documentation integrity. Clinical NLP systems can interpret context, extract relevant medical entities, and structure documentation for accurate coding and reporting.
Technology integrates with EHR platforms, coding environments, and secure chart exchange systems to streamline operations and improve collaboration between coders and healthcare organizations.
NLP tools help extract and organize information across multiple systems and formats, improving efficiency and data accessibility.
Analytics and Performance Monitoring
Dashboards and reporting tools help track:
This helps organizations monitor and optimize risk adjustment operations.
A sleek healthcare analytics dashboard on a large monitor showing bar charts, line graphs, and KPI tiles for coding accuracy, HCC capture rates, and chart volumes. Deep navy and teal palette, dark UI theme, soft office background blur. No text, no people, photorealistic, 16:9.
Human + Technology Approach
Combining Coding Expertise with Intelligent Automation
Accura RCM follows a human-assisted technology model where software enhances efficiency while certified coding professionals validate clinical accuracy and regulatory compliance.
This ensures:
- faster chart review
- improved coding accuracy
- better documentation visibility
- scalable operations
- reduced operational burden
- strong compliance and audit readiness
NLP and AI tools support coding teams, but human expertise remains essential to ensure clinical accuracy and regulatory alignment.
This creates a balanced and reliable risk adjustment workflow
What Makes Accura RCM’s Risk Adjustment Services Effective
A Structured Approach to Accuracy, Compliance, and Scalable Performance
Certified Expertise & Regulatory Alignment
Our certified coding professionals (CPC, CRC, CCS) bring deep experience across ACA, Medicare, and Medicaid guidelines, ensuring accurate HCC capture, no leakage, and strict compliance with CMS and payer-specific requirements.
Layered Quality & First Pass Accuracy
Every chart undergoes structured, multi-level quality reviews to ensure documentation integrity and coding precision, delivering 98%+ accuracy and completeness while minimising rework and eliminating multiple chart passes.
Technology Enabled Workflow & Control
We leverage industry-standard coding platforms, EHR-integrated systems, and NLP-assisted workflows, supported by a robust workflow management platform that provides real-time visibility into production, quality, and performance analytics.
Scalable Operations with Cost Efficiency
Our flexible delivery model allows teams to scale based on volume and project needs, including the ability to set up dedicated delivery centres aligned to your workflows and SLAs, at a clear cost advantage of ~$2.5 per chart.
Measurable Impact
on Outcomes
By reducing rework, improving accuracy, and optimizing workflows, Accura RCM helps organizations lower operational costs, strengthen RAF outcomes, and reduce audit exposure, delivering measurable financial and compliance impact at scale.
Expanded
Capabilities
Beyond core risk adjustment, we support Prospective CDI and help strengthen RADV readiness, enabling a more comprehensive and future-ready approach to risk management.
What Makes Accura RCM’s Risk Adjustment Services Effective
A Structured Approach to Accuracy, Compliance, and Scalable Performance
Certified Expertise & Regulatory Alignment
Our coding team includes professionals with CPC, CRC, and CCS credentials, ensuring deep expertise in HCC coding, Medicare Advantage, and ACA risk adjustment methodologies.
Layered Quality Review
Each chart goes through structured multi-level quality checks to maintain coding accuracy, documentation integrity, and regulatory compliance.
Technology-Assisted Workflow
Accura RCM works with industry-standard coding platforms, EHR-integrated systems, secure chart exchange environments, and analytics-driven review tools to improve productivity, consistency, and turnaround time.
Scalable Operational Support
Coding teams expand or adjust based on project size, review cycles, and organizational needs, allowing healthcare partners to manage both routine and high-volume chart reviews.
Regulatory Alignment
All workflows are designed to remain aligned with CMS requirements, Medicare Advantage guidelines, ACA risk adjustment standards, and payer-specific documentation rules.
Technology-Enabled Risk Adjustment Support
Accura RCM combines certified coding expertise with intelligent software tools and NLP-assisted workflows to enhance accuracy, improve efficiency, and support scalable risk adjustment operations.
Our Risk Adjustment Coding Process
A Structured and Compliant Chart Review Framework
Accura RCM follows a systematic review process designed to ensure clinical accuracy, documentation integrity, and regulatory compliance.
Prospective Reviews
Patient records are evaluated before claim submission to identify documentation gaps and potential HCC capture opportunities.
Concurrent Reviews
Coding support is provided during patient encounters to improve documentation quality and strengthen diagnosis capture.
Retrospective Reviews
Historical charts are reviewed to detect missed diagnoses and ensure accurate HCC reporting and RAF score alignment.
Documentation Integrity Review
Clinical documentation is validated using structured frameworks such as MEAT and TAMPER to ensure diagnoses are supported appropriately.
Comprehensive Audit Review
Senior auditors conduct final compliance checks to verify coding accuracy, CMS alignment, and documentation support.
Prospective Reviews
Patient records are evaluated before claim submission to identify documentation gaps and potential HCC capture opportunities.
Concurrent Reviews
Coding support is provided during patient encounters to improve documentation quality and strengthen diagnosis capture.
Retrospective Reviews
Historical charts are reviewed to detect missed diagnoses and ensure accurate HCC reporting and RAF score alignment.
Documentation Integrity Review
Clinical documentation is validated using structured frameworks such as MEAT and TAMPER to ensure diagnoses are supported appropriately.
Comprehensive Audit Review
Senior auditors conduct final compliance checks to verify coding accuracy, CMS alignment, and documentation support.
Common Risk Adjustment Challenges We Help Solve
Healthcare organizations typically require support with:
- strengthening clinical documentation quality and identifying gaps
- managing high chart volumes without affecting turnaround time
- ensuring demographic and clinical data alignment for accurate RAF scoring
- reducing CMS and payer audit risks
- supporting Medicare Advantage and ACA risk adjustment initiatives
- maintaining consistent and compliant HCC capture across large populations
Accura RCM provides structured operational support to help organizations maintain stable and compliant risk adjustment workflows.
Who We Serve
Health
Plans
Supporting Medicare Advantage, Medicaid and ACA plans with accurate HCC coding and documentation review
Provider
Groups
Helping physician networks and medical groups strengthen risk adjustment documentation and RAF accuracy.
Accountable Care Organizations
Supporting value-based care models with structured coding and chart review processes.
Healthcare Management Organizations
Providing scalable risk adjustment support to improve operational efficiency and compliance.
Compliance & Data Security
Built on Healthcare Data Protection Standards
Our operational framework includes:
- secure chart exchange environments
- controlled access systems
- HIPAA-aligned data protection protocols
- encrypted data handling processes
- secure workflow management systems
- strict confidentiality and compliance standards
Frequently Asked Questions
Reviews typically include outpatient documentation, physician notes, clinical records, discharge summaries, and other documentation where HCC-related diagnoses may be present.
Turnaround time depends on chart volume and project scope. With structured workflows and scalable coding teams, Accura RCM can manage both routine reviews and large chart backlogs efficiently.
All coding processes follow strict healthcare data protection standards with secure systems, controlled access environments, and compliance-focused workflows to protect patient information.
Yes. Organizations may require support during peak risk adjustment cycles or ongoing coding assistance throughout the year. Our operational model supports both.