Featured Case Study
HCC
HCC coding software that captures the care you deliver.
Find what’s being missed. Capture more supported revenue without adding work for providers.
SOC 2 Type II · HIPAA Compliant · HITRUST Certified
The problem
The right diagnosis can still get missed.
The revenue opportunity is often already in the chart. A condition is documented, clinically supported, and then never captured as an HCC. One missed diagnosis is easy to overlook. Thousands are not.
At scale, that means asking coders to search through thousands of records to find the handful of encounters that warrant deeper review. The more volume, the harder it is.
How HCC works
Focus coders where they matter.
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01
Review every encounter at scale
Every encounter, evaluated. No more retrospective chart review.
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02
Find the hidden value
Surface uncaptured conditions, missing specificity, and codes that may need to come out — then prioritize opportunities by potential RAF impact.
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03
Save coder time
Put expertise where it can move the needle. Route only meaningful opportunities for review, then track the the RAF value captured.
Key features & benefits
Grow the population, not the workload.
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Review at scale. Work by exception.
Evaluate every eligible encounter concurrently and send coders only the cases worth their time.
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Keep the record
Tie diagnoses back to the documentation that supports them. HCC accuracy goes up. Unsupported coding drops. Audit-readiness improves.
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Know where value is
Track HCCs added and removed, recapture, provider trends, coder activity, and RAF impact. Have a clear view of where the program is creating value — and where opportunities remain.
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No new workflow
Finalized encounters flow from the EHR into HCC for review, then approved coding changes return to the revenue cycle workflow.
Who it's for
Built for the people who turn care into value.
See where capture and recapture fall short across providers, locations, and plans — before the gaps compound.
Stop treating every chart the same. Put coder time where documentation, specificity, and RAF impact make the difference.
Turn coding patterns into targeted feedback instead of broad education and repeat queries.
Know what risk-adjusted revenue is being captured — and what’s still being left on the table. Quantify opportunity, track performance, and connect HCC accuracy to financial impact.
Every HCC has a defensible clinical record behind it. Trace what was identified, reviewed, added, and removed. Reduce exposure without slowing the coding team.
Customer results
Real numbers. Measured outcomes.
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Center for Primary Care
37-physician primary care group
$6MRAF value in year one
Coders moved from checking every encounter against paper lists to uncovering $6M in RAF value.
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South Bend Clinic
Largest physician-owned multispecialty clinic
34% RAF increase
The move into value-based care and risk-based contracts paid off: $504K in additional RAF value in less than two months, with just one HCC coder.
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Arizona Community Physicians
166-provider group
53 sites, 2 coders
A six-step manual process covered just 12 locations with three full-time employees. An automated workflow extended HCC review across all 53 sites with two coders.
Common questions
Answered clearly, no sales pitch.
What is HCC coding software?
HCC coding software looks through finalized encounters to find what may have been missed: a supported condition that never made it into the coding, a diagnosis that lacks specificity, or a code that may need to come out. It gives coders a better place to start.
How does HCC coding software improve RAF accuracy?
Stop asking coders to search thousands of records for the few that matter most. HCC evaluates every eligible encounter, surfaces potential gaps, and ranks them by potential RAF impact.
Does HCC coding replace the coder?
No. It changes where coders spend their time. HCC clears correctly coded encounters and puts the cases that require clinical and coding judgment in front of the right people.
Does every encounter require manual review?
No. Every eligible encounter gets evaluated; only potential opportunities reach the coding team. The rest keep moving.
What types of HCC coding gaps can it identify?
Find the condition that was documented but never captured. Catch diagnoses that need greater specificity. Flag codes that may no longer be supported. Your coders make the final decision.
How does HCC coding support compliance?
Keep the documentation behind the diagnosis. HCC connects recommendations to the available clinical record and maintains a traceable history of what was reviewed, added, and removed.
Does it work with the EHR?
Find the value you're missing.
See how HCC Coding can help you find supported opportunities and put coder capacity where it matters.
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