epitomi® Risk Adjustment

Empowering healthcare organizations
with precise, efficient, and comprehensive risk adjustment solutions
epitomi® RA

Predict the undocumented. Close the gaps - compliantly

epitomi® RA doesn’t just look at what’s been documented—it predicts what’s missing, surfaces gaps in specificity and causal linkages, and cues annual recapture. By integrating clinical and social determinants of health (SDoH), we provide a truly holistic view of patient risk.
This deeper insight allows you to not only secure accurate reimbursement but also to allocate resources effectively, and drive health equity.

End-to-End Risk Adjustment Solution

epitomi® RA streamlines every step of the risk adjustment process, from identifying at-risk populations to ensuring compliant submissions, all on a single, intelligent platform.

Precision & Accuracy

Utilize advanced AI and accurate Hierarchical Condition Category (HCC) coding to capture patient complexity and align reimbursements with true health status.

Integrated Intelligence

Seamlessly unify data from EHRs, claims, and third-party sources. Get real-time analytics to monitor risk scores and identify care gaps proactively.

Enhanced Outcomes & Efficiency

Identify high-risk patients for targeted interventions, improve care management, and streamline administrative tasks to focus resources on what matters most—patient health.

Proven Results. Measurable Impact.

We partner with leading health plans and providers to deliver
exceptional financial and clinical outcomes.

98%

Average Coding Accuracy

+20%

Increase in RAF Score Capture

10M+

Patient Records Analyzed

Powered by Enterprise-Grade Healthcare AI

epitomi® RA extends our proven epitomi® Clinical Data Platform with specialized risk adjustment capabilities. Key platform strengths include advanced healthcare NLP, real-time clinical document processing, enterprise-grade security (HIPAA/SOC2), multi-cloud SaaS architecture, and FHIR-native interoperability.

To learn more about epitomi® Risk Adjustment