Validated Accuracy. Measurable Savings. Built to Scale.
Revenue Align Edge: Retrospective Risk Adjustment combines proprietary artificial intelligence (AI)-powered Hierarchical Condition Category (HCC) classification with certified coder validation to streamline chart review. The result: 99%+ coding accuracy and up to 60% lower effective coding costs, with savings redirected back into your program. Delivered without disrupting the workflows your team already relies on, and built to hold that performance steady as chart volume grows.
Get a Clear Picture of Risk Adjustment
What Makes Us Different
Touchless AI Triage: Classification That Happens in Real Time
Most AI coding tools sit outside the existing process, which means they add a step instead of removing one. Revenue Align Edge Retrospective coding is different. AI is embedded directly into your existing coding workflow, so charts are classified the moment they arrive with no batching, no delays, and no separate review queue at a speed that holds steady whether you're processing thousands of charts or millions.
- Real-time classification
- Over 99% classification accuracy, validated by certified coders
- No workflow disruption or process overhaul required
Coder Focus on Complex Charts: Human Judgment Where It Counts
Automation doesn't replace clinical expertise, but directs it. Certified coders validate every result and apply their judgment to the complex cases that actually need it. The routine work is handled, the hard work gets the attention it deserves, and that balance is what keeps accuracy consistent as your program grows.
- Applied human validation and quality assurance (QA)
- Certified coders freed to focus on complex cases
- Consistent accuracy maintained at scale
Cost Reduction at Scale: Efficiency That Compounds Over Time
Improving chart categorization and review isn't just an operational improvement, it's a durable advantage. What starts as a pilot becomes an enterprise-wide transformation in managing coding costs.
- 30 to 60% reduction in effective coding costs per chart
- Redirect savings into member care instead of administrative overhead
- Scale to millions of charts
AI-Powered Coding Platform
A configurable, AI-powered coding platform that combines natural language processing, optical character recognition (OCR), and autonomous classification to identify HCCs across structured and unstructured medical records.
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Submissions
An end-to-end Encounter Data Processing System (EDPS) platform that formats, validates, submits, and reconciles encounter data to help ensure timely, compliant reimbursement from the Centers for Medicare & Medicaid Services (CMS).
The Retrospective Solution Suite
As CMS expands Risk Adjustment Data Validation (RADV) audit scope, Revenue Align Edge: Retrospective Risk Adjustment delivers audit strategy, execution, and RADV support services that strengthen coding accuracy and help plans prepare with confidence for regulatory review.
Revenue Align Edge Suite
Revenue Align Edge
Revenue Align Edge enables proactive management and stronger compliance across the payer enterprise by giving payers a clear, data driven picture of risk adjustment, aligning prospective and retrospective risk so you can capture accurate, complete, and compliant documentation with confidence.
Retrospective Risk Adjustment
Automated chart review and audit-ready submission to capture every documented condition.
Precision at Scale
The HCC identifier solution classifies charts in real time, so certified coders spend their time on complex charts. Lower costs without sacrificing accuracy, validated by certified coders.