Revenue Align Edge
Risk adjustment is only as strong as the data behind it. Revenue Align Edge enables health plans to have a clear, data-driven picture of risk adjustment, by aligning prospective and retrospective programs that provide outcomes which translate directly into stronger compliance and lower administrative spend.
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What Makes Us Different
Revenue Align Edge brings accuracy and transparency to risk adjustment across coding, operations, and technology teams to give health plans an enduring precision edge.
Accurate Risk Scores, Backed by Evidence
Revenue Align Edge pairs proprietary context-aware artificial intelligence (AI) with American Health Information Management Association (AHIMA)- and American Academy of Professional Coders (AAPC)-certified coders who validate every classification against clinical documentation. This combination of AI-driven technology and applied human coding expertise builds risk scores your compliance team can defend today and rely on as your program grows in operational excellence.
- 99%+ coding accuracy
- Per-chart savings of 30-60%
- Clinical documentation integrity across every chart
A Unified Risk Adjustment Lifecycle
Disconnected prospective and retrospective processes leave gaps in your risk picture and force teams to solve the same problems twice. Revenue Align Edge connects point-of-care engagement with retrospective review into one continuous, data-driven workflow, helping your teams operate more efficiently and respond faster as programs expand across new lines of business.
- 5-8% risk score accuracy improvement
- Single source of truth from point-of-care to final coding
Audit-Ready by Design
Every code in Revenue Align Edge is linked to its supporting clinical evidence. As Centers for Medicare & Medicaid Services (CMS) expands Risk Adjustment Data Validation (RADV) audit scope, your compliance team needs a defensible record ready before a request arrives. Revenue Align Edge absorbs that operational burden by building the record into every workflow from the start, within a HITRUST-certified ecosystem, so audit readiness holds steady as your program scales.
- Traceable decision framework
- Audit-ready documentation at scale
- Reduced RADV exposure
Prospective Risk Adjustment
Prospective risk adjustment synchronizes data at the point-of-care through delivery models tailored to how each provider operates. This alignment helps plans capture accurate risk scores before ever submitting a claim, reducing the downstream burden on retrospective review and improving accuracy from the start.
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Point-of-care gap identification
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Provider & coder enablement
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Real-time suspecting
Retrospective Risk Adjustment
Retrospective coding combines proprietary context-aware AI with certified coders to deliver accurate, audit-ready results across multiple populations. A traceable decision framework links every code to its supporting clinical evidence, giving compliance teams a defensible record at scale.
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Automated chart retrieval
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Coding accuracy & validation
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Audit-ready submission
Revenue Align Edge Suite
A Clear Picture of Risk Adjustment Across the Enterprise
From point-of-care documentation to certified retrospective review, Revenue Align Edge delivers accurate, audit-ready results at every stage of the risk adjustment lifecycle.