Risk Adjustment

Ensure Compliant, Audit-Ready Risk Adjustment

Stop leaving money on the table. Carevyn’s AI-driven risk adjustment solution captures every condition accurately, improves compliance, and strengthens audit readiness for long-term success.

Risk adjustment is often prone to missed codes, documentation gaps, and compliance risks. Carevyn’s AI ensures every chronic condition, HCC code, and quality measure is accurately captured and backed by clinical evidence—helping providers and payers get paid fairly.

Risk Adjustment with Clinical and Financial Integrity

Why Carevyn for Risk Adjustment?

  • 99%+ Compliance Accuracy – Every code is backed with evidence and audit-trail support.
  • 15–20% Revenue Uplift – Recover lost reimbursement opportunities.
  • Automated Evidence Linking – Clinical notes mapped directly to supporting documentation.
  • Real-Time Coding Gaps Closure – No delays in condition capture.
  • Audit-Ready Confidence – SOC 2 and HIPAA-certified framework.

How It Works – From Encounter to Accurate Risk Score

Step 1 – Detect

AI scans clinical notes and structured data to identify missing HCCs and chronic conditions.

Step 2 – Validate

Evidence-backed mapping ensures compliance and coding accuracy.

Step 3 – Capture

Codes are applied, flagged, and optimized for risk score improvement and reimbursement alignment.

Results That Matter

📈 15%
RAF Score Increase

Within year one for Carevyn clients.

99%
Coding Compliance

With complete evidence linking.

💰 $1M+
Annual Reimbursement Gains

For mid-sized health systems.

🛡️ 0
Audit Penalties

Zero penalties in payer reviews.

Who Benefits Most?

  • Providers & Health Systems – Close coding gaps, improve population health reporting.
  • Health Plans (Payers) – Ensure compliant risk scoring across member populations.
  • ACO & MA Organizations – Drive accurate RAF scores for value-based care success.

Security & Compliance First

  • HIPAA-Compliant documentation workflows.
  • SOC 2 Certified infrastructure.
  • Full audit trails with evidence-backed coding.

Ready to Strengthen Your Risk Adjustment Strategy?

With Carevyn AI, you get compliance, accuracy, and revenue integrity—all in one solution.