HCC Suspecting

This flow improves risk scores by reasoning through notes to find missing diagnoses. It improves RAF scores, reduces the time that physicians spend scrubbing charts, and increases compliance with documentation requirements.

This flow is triggered on upcoming appointments for eligible patients in Medicare, Medicaid, or related populations, and runs proprietary, clinically-validated Hierarchical Condition Category (HCC) suspecting algorithms to check for evidence of undocumented HCC conditions within the patient's existing chart data (structured and unstructured). This chart review is performed prior to the patient's visit to proactively flag conditions that may not yet be on the problem list. If a suspected HCC condition is found, the evidence is exported to the EMR, integrated directly into your existing provider workflow (e.g., problem list, pre-visit checklist, or an in-basket notification) for the provider to review and either diagnose or disagree during the upcoming visit / visit prep. This process ensures that clinically validated risk-adjusted conditions are surfaced efficiently, promoting complete and accurate documentation during the visit.