CMS V28 Model Compliant

Intelligent HCC Coding for Risk Adjustment

AI-powered clinical NLP engine that identifies missed HCC opportunities, validates coding accuracy, and maximizes legitimate RAF capture. Built for ACOs, MSOs, and value-based care organizations.

Or try: HCC LookupRAF CalculatorAPI DocsFAQ
7,900+
HCC-Mapped ICD-10 Codes
115+
Clinical Rule Families
33K+
SNOMED Mappings

Complete HCC Coding Suite

Purpose-built tools for every step of the risk adjustment workflow

HCC AutoCoder

Paste clinical notes and instantly identify HCC opportunities. Deep NLP analyzes assessment, plan, medications, and lab values to surface missed diagnoses with supporting evidence.

Live

HCC Lookup

Search 7,900+ ICD-10 codes with HCC mappings, RAF values, and clinical synonyms. Instant lookup by code, description, or clinical term with SNOMED crosswalk.

Live

RAF Calculator

Calculate Risk Adjustment Factor scores with demographic adjustments. See HCC interactions, hierarchy impacts, and payment count coefficients in real-time.

Live

EMR Integration

FHIR R4 connectivity for seamless EHR integration. Pull patient data, analyze full charts, and push coding suggestions back to your workflow.

Coming Soon

Chart Audit

Comprehensive retrospective chart review with compliance scoring. Identify documentation gaps, coding opportunities, and RADV audit risks across your patient population.

Coming Soon

API Documentation

RESTful API for enterprise integration. Analyze notes programmatically, batch process charts, and embed HCC intelligence into your existing systems.

Live

ChartCopilot

Deep AI-powered chart analysis with comprehensive code capture. Multi-LLM workflow takes 2-3 minutes per note but provides highly accurate results with detailed user dashboard and feedback system. Requires login.

AI-Heavy

Redact iPHI

Keep PHI out of your AI stack. Joinable de-identification with audit receipts at the pipeline edge. De-identify clinical notes without breaking analytics or downstream processing.

Privacy

Built for Clinical Accuracy

Millions of lines of clinical coding logic built by clinician-programmers, powered by evidence-based algorithms

Clinician-Built Logic

Millions of lines of clinical coding algorithms developed by clinician-programmers who understand real-world documentation patterns.

Evidence-Based Coding

Every suggestion backed by hard clinical evidence - medications, labs, procedures, and documented findings. No guesswork.

40,000+ Clinical Phrases

Tens of thousands of clinical terms, synonyms, and documentation patterns for comprehensive NLP matching and AI enhancement.

Real-Time Analysis

Sub-second response times for point-of-care coding support. No batch delays or overnight processing.

AI-Enhanced

Deep learning models augment rule-based logic for context-aware coding suggestions with negation and uncertainty detection.

CMS V28 Native

Built for the latest CMS-HCC model with automatic hierarchy application and disease interaction calculations.

Understanding RAF & Why It Matters

The Risk Adjustment Factor (RAF) is a numerical score that predicts a Medicare Advantage member's expected healthcare costs. Accurate RAF capture ensures appropriate reimbursement for the care your patients actually need.

Each HCC diagnosis adds to a patient's RAF score. Missing even one chronic condition can mean thousands in lost annual revenue per patient.

Capture Missed Diagnoses

AI identifies conditions documented but not coded

Specificity Upgrades

Find opportunities to code more specific diagnoses

Hierarchy Optimization

Automatic HCC hierarchy application for accurate totals

EXAMPLE RAF CALCULATION
Diabetes w/ Chronic Complications (HCC 18) +0.302
CHF (HCC 85) +0.323
CKD Stage 4 (HCC 327) +0.289
CHF + CKD Interaction +0.150
Total HCC RAF 1.064

Who Uses HCCapture

Trusted by organizations across the value-based care ecosystem

ACOs

Optimize shared savings with accurate risk scoring across attributed populations

MSOs

Scale coding operations with AI-assisted chart review and quality metrics

Health Plans

Prospective chart review and provider education for MA populations

Clinicians

Point-of-care coding support for MDs, PAs, APRNs, and NPs

Ready to Optimize Your RAF Capture?

Start analyzing clinical notes in seconds. No signup required for basic features.

Launch HCC AutoCoder View API Docs