Prospective Risk Adjustment without Slowing Clinicians
Provide pre-visit and in-visit recommendations that are evidence linked and MEAT-aware. Empower providers to act quickly while ensuring coding stays defensible and risk score accuracy improves.
D4H's prospective risk adjustment solution is built for payers, providers, and auditors operating in high-compliance, value-based care environments, specifically aimed at optimizing Hierarchical Condition Category (HCC) coding, reducing the need for retrospective chart reviews and mitigating your exposure under RADV audit rules.
Enterprise Performance
Technology Built for Enterprise Scale
Workflow-first suggestions
Built for clinic reality: concise, actionable, and fast to validate at the point of care.
Evidence-linked + MEAT-aware
Clear “why” and documentation signals to reduce noise and minimize provider friction.
Deployed inside your environment
Cloud/VPC or on-prem options ensure PHI stays under your control at all times.
Compliance & Precision
Built for Trust and Accuracy
D4H is designed for environments where compliance, precision and transparency are non-negotiable.
More captured value
Find supported, under coded HCCs with evidence packaged for action.
Less wasted review time
Page-level evidence and provenance reduce "PDF hunting" and speed decisions.
Stronger audit posture
MEAT-aware findings help prevent overcoding and improve RADV readiness.
Higher trust output
Every recommendation ships with "why", so reviewers can validate in seconds.
Built to run at scale
Designed for high-volume retrospective workflows across millions of records with consistent output quality.
Deployed inside your environment
Runs in your cloud/VPC or on-prem to keep PHI safe under your control. No external data egress required.
Our Process
One Simple Flow for Prospective Coding
Plan the visit → document with confidence → close prospective risk adjustment gaps before they hit retrospective
Pre-visit gap detection
Start with a tight, prioritized set of risk gaps per member.
- Identify likely supported conditions based on documentation
- Prioritize by expected impact and evidence strength
- Route work to the right clinic, provider, or team
Point-of-care suggestions
Make it easy to act: concise, evidence-linked, and MEAT-aware.
- Show "what to document" cues (MEAT evidence)
- Include provenance so clinicians can validate quickly
- Guardrails to reduce unsupported coding and noise
Close the loop
Turn actions into measurable outcomes and downstream readiness.
- Export outcomes for QA, analytics, and submissions
- Track adoption, lift, and documentation gaps
- Improve future suggestions with your feedback
Enterprise Ready
Outputs Built for Scale
Every suggestion is packaged with the context and evidence required for immediate action.
MEAT Evidence
Explicit linkage to Monitoring, Evaluation, Assessment, or Treatment evidence within the clinical record.
Provenance
Direct deep-links to the original note text, date of encounter, and source system for total traceability.
Prioritization
Customized confidence and impact thresholds tailored to fit your organization's unique risk profile.
Designed for Humans
High signal, low noise, so clinicians don't tune it out
Prospective success is adoption. Adoption requires precision, brevity, and defensibility.
MEAT-aware recommendations
Every recommendation is supported by documented Monitoring, Evaluation, Assessment, or Treatment evidence.
Evidence provenance
Complete note/date/source traceability enabling clinicians to validate quickly and confidently.
Prioritization + thresholds
Fit your standards and risk tolerance with customizable prioritization and confidence thresholds.
Deployment control
Deploy on cloud, VPC, or on-premises—PHI stays under your control with flexible deployment options.