Unlike generic AI tools, HDM is built specifically for risk adjustment workflows — coding, encounters, analytics, and audits — all connected in one governed platform.
At the core of Health Data Max is Agentic AI — a multi-agent intelligence designed for the realities of healthcare risk adjustment. These AI agents continuously work across charts, claims, and CMS files, connecting the dots, validating outputs, and adjusting as CMS models evolve.
The result: accurate, defensible, and compliant outcomes — end to end.
Smarter Chart Reviews, Faster Decisions
Scans structured and unstructured clinical data using NLP and fine-tuned LLMs
Identifies HCCs and missed coding opportunities
Provides compliant code suggestions with source-linked evidence
Supports prospective, concurrent, and retrospective reviews
Maintains a full audit trail
Integrates seamlessly with EHRs and coding platforms
Confidence Across Every Submission
Analyzes X12 837 I / P / D encounter files
Monitors TA1, 999, 277CA, MAO-002, MAO-004, MMR, and MOR responses
Flags rejected or dropped encounters in real time
Reconciles issues back to source charts to prevent revenue loss
Better RAF, Without Over-Coding Risk
Identifies undocumented HCCs with clinical context
Prioritizes high-impact, chronic conditions
Supports prospective programs before look-back deadlines
Flags over- and under-coding risks
Predicts RAF impact and submission completeness
Turn chart reviews into fast, reviewer-ready intelligence — without compromising compliance.
Validated with MEAT evidence and historical CMS signals for cleaner coding and RADV readiness.
While you sleep, AI prioritizes your highest-impact chart reviews—ready when your team logs in.
From targeting to audit—intelligent agents keep risk adjustment accurate, compliant, and revenue-safe.
Join our exclusive beta program and be among the first to experience autonomous AI for healthcare
