Risk scores that reflect real patient complexity — and hold up under audit.
HCC coding and prospective risk adjustment support built for value-based and Medicare Advantage contracts.
0.0%
HCC coding accuracy
0%
Average recapture improvement
RADV-ready
Documentation standard
How Sevynox approaches hcc coding & risk adjustment
Accurate risk adjustment factor scoring is essential to value-based contract performance, but it only matters if it's defensible. Sevynox HCC coders specialize in both accurate capture and audit-ready documentation support.
We support prospective chart review ahead of annual wellness visits as well as retrospective HCC recapture, so risk scores reflect the full picture of patient complexity — accurately, every year.
Works well for
What changes once this is running.
Accurate RAF capture
Chronic conditions are captured completely and correctly, every measurement year.
Audit-ready documentation
Every HCC code ties back to defensible clinical documentation.
Prospective + retrospective coverage
Pre-visit chart prep and post-visit recapture review in one program.
Provider education support
Targeted feedback helps providers document chronic conditions more completely at the point of care.
How an engagement actually runs.
Prospective chart prep
Charts are reviewed ahead of annual wellness visits to surface suspected conditions.
Point-of-care support
Providers receive a concise suspect list to confirm or rule out during the visit.
Retrospective recapture review
Completed charts are reviewed to confirm all documented conditions are coded.
Audit-readiness QA
A sample of charts is reviewed against RADV documentation standards continuously.
What's included.
Suspect condition analytics
Data-driven identification of likely undocumented chronic conditions.
RADV-ready documentation review
Every capture is checked against defensibility standards, not just presence of a code.
Provider-facing suspect lists
Delivered ahead of the visit in a format that fits clinical workflow.
RAF trend reporting
Risk score trends tracked by population, provider, and measurement year.
The AI layer behind this service.
Predictive suspect modeling
Claims and clinical history are analyzed to surface likely undocumented HCC conditions.
NLP chart mining
Unstructured notes are scanned for documented-but-uncoded chronic conditions.
RADV simulation review
Charts are stress-tested against audit standards before submission season, not during it.
Medicare Advantage-focused physician group, 60 providers
Challenge — A physician group participating in multiple Medicare Advantage contracts had no formal prospective review process, leading to consistent under-capture of chronic condition documentation.
Approach — Sevynox implemented prospective chart prep ahead of annual wellness visits alongside retrospective recapture review and provider education.
0%
Improvement in HCC recapture rate
0
Adverse RADV audit findings since program start
0.0%
HCC coding accuracy achieved
Questions we hear most.
See what hcc coding & risk adjustment looks like on your own claims.
A working session with our team, scoped to your specialty mix and payer contracts — not a generic slide deck.