Intelligent Medical Coding and Risk Adjustment Systems

Intelligent medical coding automates the assignment of standard codes to clinical documents. These codes are employed to support revenue generation, audit preparedness, claims reimbursement, and risk stratification for population health and value-based care management. Risk adjustment attempts to quantify the influence of socio-demographic factors, clinical conditions, resource utilization, and care giver attributes on health system performance metrics. Accurately accounting for these influences helps ensure that care quality is appropriately recognized and penalized or rewarded.