About Us

 
 

Health Data Max was born from a simple observation: healthcare organizations were drowning in data but starving for insights.

We witnessed firsthand how manual chart review processes were not only inefficient but also led to millions in lost revenue and compromised patient care. Our founders, with combined experience in healthcare technology and machine learning, set out to build the autonomous AI platform that the industry desperately needed.

We strive to Power smarter risk and quality outcomes across healthcare. 

At Health Data Max, we equip payers, providers, and ACOs with advanced risk adjustment and quality analytics solutions—designed to drive better care, stronger compliance, and improved financial performance. 

Our intuitive, AI-powered SaaS platform transforms how organizations manage clinical and claims data—simplifying operations while ensuring accuracy in every submission. With robust analytics, actionable insights, and built-in regulatory intelligence, we help you uncover opportunities, close gaps, and stay audit-ready. 

Whether you're focused on risk capture, quality scores, or end-to-end value-based performance, our tools and team are here to help you lead with confidence. 

Our Risk Adjustment suite is powered by Agentic AI—a system of autonomous validation agents that continuously analyze CMS submission files, response reports, claims, and member profiles. Each agent cross-checks diagnoses, verifies data integrity, and ensures reimbursement accuracy in real time.
These agents work alongside fine-tuned LLMs trained on RADV and CMS-HCC guidelines to interpret documentation with expert precision. They identify unsupported diagnoses, missed HCCs, and hierarchy conflicts before submission, reducing payment errors and ensuring compliance with CMS audit standards.

Ready to see it in action? Schedule a personalized demo 

(571) 295-8107

Email: sales@healthdatamax.com

 
 

Our Mission & Values

Our mission is to democratize advanced AI technology for healthcare organizations of all sizes, enabling them to unlock the full potential of their data while improving patient outcomes and organizational efficiency.

 

Innovation First

We continuously push the boundaries of what's possible with AI in healthcare, always staying ahead of industry needs.

 

Security & Compliance

We maintain the highest standards of data security and regulatory compliance in everything we do.

 

Patient-Centric

Every solution we build ultimately serves to improve patient care and outcomes through better data insights.

Partnership

We work closely with our customers as true partners, understanding their unique challenges and goals.

 
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Who We Serve

 
 

Payers - Medicare Advantage

Risk Adjustment Data Submission & Analytics

Closing Care Gaps. Maximizing Reimbursement. Staying CMS-Compliant.

For Medicare Advantage (MA) plans, success depends on accurate risk adjustment data submissions and smart analytics. CMS requires encounter data (EDS) submissions through the MARx and Encounter Data System, and even small errors can mean missed reimbursement opportunities. That’s where Health Data Max comes in.

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ACA Risk Adjustment (Payers - Marketplace)

Smarter Programs for Marketplace Plans

The Affordable Care Act (ACA) opened new opportunities for payers but also introduced unique challenges. Since plans cannot deny coverage based on pre-existing conditions, issuers face significant financial risk when a higher proportion of high-cost members enroll.

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Providers

Empowering Accurate Coding, Quality Care, and Shared-Savings Success

As Medicare Advantage (MA) grows—now covering more than 33 million beneficiaries in 2024 (CMS)—payers and providers face increasing pressure to close coding and care gaps, improve quality scores, and protect revenue in risk-sharing arrangements.

That’s where Health Data Max (HDM) helps providers thrive.

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ACO & VBC Networks

For ACOs: Make Risk Adjustment a Competitive Advantage

Value-based care is now the norm—not the exception. CMS continues to expand ACO participation and front-load primary-care investment (e.g., ACO Primary Care Flex in MSSP starting 2025–2029, and the Making Care Primary model launched July 1, 2024), reinforcing accurate documentation, coordinated care, and equity as core levers for performance. Centers for Medicare & Medicaid Services

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