Wolters Kluwer Risk Adjustment Solution (SaaS)

Survive RADV audits with confidence. The Health Language Coder Workbench provides a project management tool that maximizes validation rates and minimizes penalties. Our cloud-based platform combines clinically trained NLP with CMS-aligned coding logic to help health plans efficiently navigate compressed 12-week timelines while coding up to 2,000 charts per contract. Smart chart organization and auto-populated ICD-10 suggestions accelerate workflows, while real-time dashboards provide operational visibility and a measurable impact across your entire Risk Adjustment program.

• 25–30% efficiency gains over manual chart review
• 5–7% net new, validated codes identified and accepted
• 10–15x ROI observed in pilot evaluations of 100 charts
• The Coder Workbench optimizes accuracy, speeds production, and elevates coder satisfaction.

Transform your Risk Adjustment Operations with the benefit of a complete RADV Audit Response solution

• Accelerate Chart Reviews: Smart table of contents and intelligently annotated charts reduce clicks and streamline coder workflows.
• Maximize Code Accuracy: Built-in coding assistant delivers precise ICD-10 and HCC recommendations using clinically enriched terminology.
• Ensure Regulatory Compliance: Integrated CMS rules and coding guidelines guarantee compliant documentation for every code recommendation.
• Unlock Hidden Value: Identify diagnoses from unstructured data that traditional claims analysis misses.
• Drive Operational Excellence: Real-time dashboards track coder performance, throughput, and project progress to optimize staffing decisions.
• Excel in RADV Audits: Purpose-built project management capabilities that automatically prioritize high-confidence encounters, select optimal charts for maximum validation rates, and generate auditor-ready reports with full traceability.