Compliant Risk Adjustment Revenue.
Powered By Governed Agentic AI.
Unlike generic AI tools, HDM is built specifically for risk adjustment workflows — coding, encounters, analytics, and audits — all connected in one governed platform.
3-Pillar Value Proposition
Designed for Risk Adjustment Reality.
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.
Chart AI Copilot
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
CMS Submission Compliance
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
RAF Optimization
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
AgentHDM
Each Agent Specializes in a Different Part of the Risk Adjustment Cycle
HCC Risk Analytics Agent
Risk Intelligence
Detects missing, miscoded, and unsorted HCCs
142 opportunities detected
97.2% accuracy
Open Agent >
ChartCopilot™ Retro
Agent
Retrospective Review
Chart extraction + MEAT → HCC detection
120 opportunities detected
Open Agent >
EncounterFlow™ Agent
Compliance Workflow
Validates encounter submissions end-to-end
352 encounters validated
95.5% accuracy
Open Agent >
ProspectiQ™ Agent
Prospective Analytics
Identifies high-value members & next-best actions
129 high-value members
98.5% accuracy
Open Agent >
Our Impact
80%
Time reduction
Turn chart reviews into fast, reviewer-ready intelligence — without compromising compliance.
98%
Validation accuracy
Validated with MEAT evidence and historical CMS signals for cleaner coding and RADV readiness.
24/7
AI processing
While you sleep, AI prioritizes your highest-impact chart reviews—ready when your team logs in.
Protect and Maximize Risk Adjustment Revenue with Audit-Ready AI
From targeting to audit—intelligent agents keep risk adjustment accurate, compliant, and revenue-safe.
360-Degree Member Data View
Validating Submissions Against Your Claims and EHR Medical Records
Advanced Clinical-AI Platform
Build Your Own Custom-Trained Large Language Model on Your Data
Proven Encounter Submissions Engine
Financial Reconciliation to Minimize Risk and Maximize Revenue
Predictive Risk Adjustment Engine
Close Predicted Gaps at the Point of Care Through EHR-Integrated Physician Workflows
Ready to Transform Your Risk Adjustment?
Join our exclusive beta program and be among the first to experience autonomous AI for healthcare