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Maximizing the Potential of Your

Risk Adjustment Coding

Unlock the full potential of your risk adjustment coding to ensure equitable healthcare payments using Emedlogix NLP tool.

CONVENTIONAL

RISK ADJUSTMENT CODING 

PATIENT

MEDICAL

RECORDS

HEALTH PLAN CODERS

Coder analyzing code charts

Coders analyze and capture HCC codes from charts and submit to Health plan

Reviewing HCC code of patient every year

REVIEW

RISK

SCORE

How risk adjustment coding works
Determine Risk score of a patient based on the submitted HCC

HCC codes 
of patient reviewed every year

Health plan determines RISK SCORE of a patient based on the submitted HCC

CMS adjust monthly  capitated payments to Health plan based on risk score

ADJUSTMENT

PAYMENT

Health plan pays the provider

CMS adjust monthly 
capitated payments to Health plan based on risk score

Health plan pays the provider

patient health risk score HCC coding

PATIENT CONDITION

"Unlock the potential of ML and NLP, transforming data into actionable insights!"

REVITALIZING RISK ADJUSTMENT CODING THROUGH EMEDLOGIX NLP

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Emedlogix receives medical records as PDF, word and other formats

STEP 1

EmedlogixNLP receives Medical records as PDF/IMAGE/WORD/
CCDA or any other formats from Health plan.

STEP 2

EmedlogixNLP 
extract key terms 
from medical records.

How EmedlogixNLP  extract key terms  from medical records
how EmedlogixNLP converts key terms to ICD-10-CM codes.

STEP 3

EmedlogixNLP converts key terms to ICD-10-CM codes.

STEP 4

EmedlogixNLP 
applies ICD-10-CM, HCC & other terminology guidelines.

EmedlogixNLP  applies ICD-10-CM, HCC & other terminology guidelines
Prepares finalized list of extracted codes and publishes them.

STEP 5

Prepares finalized list of extracted codes and publishes them.

STEP 6

EmedlogixNLP performs audits as per client-specific guidelines & compares code lists for missed opportunities and coding errors.

EmedlogixNLP performs audits as per client-specific guidelines & compares code lists for missed opportunities and coding errors.

How Emedlogix Enhances Risk Adjustment Coding

Emedlogix-NLP, the groundbreaking Natural Language Processing (NLP) solution designed specifically for risk adjustment coding in the healthcare industry.

Application built on top of Advanced AI, Enhanced ML  and Versatile NLP to reduce Medical Coding Errors and achieve an extremely high level of Automation, Accuracy, and Efficiency.

Prospective risk adjustment examines the patient's medical records to identify potential risks, detect emerging conditions, and provide timely support for patient care

Enhancing retrospective risk adjustment analysis with NLP, AI, and ML: accuracy, insights, performance from medical records.

Emedlogix enhances coder productivity through suggested ICD-10 and HCC codes, along with M.E.A.T. criteria justification including medication, orders & justification.

Emedlogix NLP logo

Proprietary NLP rules engine to convert diagnosis condition to diagnosis codes and HCCs to calculate risk scores

HOW RISK ADJUSTMENT CODING WORKS

"Empowering the future of healthcare with cutting-edge AI, ML, and NLP technologies for improved patient outcomes!"

Watch CAC demo video

Emedlogix NLP can help achieve a significant cost reduction of minimum 30% for your organization

At Emedlogix NLP, our goal is to provide cost-effective solutions for our clients

We leverage the power of natural language processing (NLP) and large language model (LLM) to optimize coding processes and reduce expenses

By streamlining coding workflows and improving accuracy, we eliminate unnecessary expenses and increase operational efficiency.

Streamlining coding workflows
Emedlogix NLP algorithm to automate coding tasks

Our advanced NLP algorithms automate coding tasks and reduce manual efforts, resulting in substantial savings.

With our cost reduction strategies, you can allocate resources more effectively and enhance your organization's financial performance.

Emedlogix nlp helps cost reduction stratergies
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