Audit Grade Evidence at Scale for Retrospective Risk Adjustment
Find uncoded and under-coded HCCs while validating persisting codes to improve risk score accuracy and minimize audit risk.
Retrospective solution is designed for internal coders, compliance teams, auditors and operational leaders at Medicare Advantage plans, Accountable Care Organizations (ACOs), and provider organizations. It is designed to help these teams to improve the accuracy of retrospective HCC coding and reduce exposure under Risk Adjustment Data Validation (RADV) audit.
Enterprise Performance
Proven technology that delivers measurable results at enterprise scale
Industry-leading performance
Validated by peer reviewed publications and third-party benchmarks.
Proven ROI
Measurable lift in throughput and captured value for our health plan partners.
Scalable by design
High-volume workloads across millions of records with consistent precision.
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
Retrospective Coding Workflow
Ingest charts → validate MEAT-backed diagnoses with evidence → recapture missed HCCs and resolve issues.
Ingest & Normalize
Pull clinical data, standardize, and de-duplicate at scale.
- Pull notes/PDFs, encounters, and claims
- Standardize and de-duplicate at scale
- Process millions of records reliably
Detect & Prioritize
Identify gaps with MEAT evidence, ranked by impact.
- Identify HCC gaps + validate existing codes
- Link each finding to MEAT evidence
- Prioritize chases by impact (RAF lift / yield)
Review & ROI
Fast reviews with linked docs and continuous improvement.
- Reviewer UI built for speed (page-level)
- Push suggestions with historical links
- Improve future suggestions with your feedback