We use agentic AI to find, capture, submit, and defend risk adjustment — end-to-end and audit-ready.

Unlike generic AI tools, HDM is built specifically for risk adjustment workflows — coding, encounters, analytics, and audits — all connected in one governed platform.

Request A Consultation

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