Capture · Comply · Optimize

Risk Adjustment Coding

Accurate, compliant, and defensible HCC coding through retrospective, concurrent, and prospective review programs, at any scale.

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2M+

Charts Supported

97%+

Coding Accuracy

100%

SLA Compliance

3

Program Types

Full Cycle Support

Risk Adjustment Services

Specialized retrospective, concurrent, and prospective Risk Adjustment coding support for strategic healthcare partners.

1

Retrospective Coding

Review of historical medical records to identify and document supported HCC diagnoses.

2

Concurrent Coding

Real-time coding support aligned to encounter workflows and program timelines.

3

Prospective Coding

Forward-looking coding strategies to support accurate, compliant risk capture.

4

HCC Validation

Second-level review and validation of HCC coding for accuracy and completeness.

5

Coding Quality Audits

Structured auditing programs to identify gaps and drive measurable accuracy improvement.

6

Reporting & Analytics

HCC capture reports, RAF score analysis, quality performance, and operational metrics.

Coding Scope

What We Code

  • ICD-10-CM Hierarchical Condition Categories (HCCs)
  • Chronic conditions across all body systems
  • Comorbidities with impact on risk scores
  • Historical diagnoses supported by clinical documentation
  • Suspect diagnoses for prospective programs
  • Encounter-level and retrospective chart reviews
  • Documentation gaps and improvement opportunities
  • RAF score-impacting diagnosis capture
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HOW WE WORK

Our Coding Process

1

Chart Assignment

2

Record Review

3

Diagnosis Coding

4

Quality Review

5

Validation & Audit

6

Reporting & Delivery

7

Feedback & Education

SUCCESS STORY

Supporting High-Volume Risk Adjustment Programs

A managed care partner needed to scale its retrospective program quickly. JITMED supported 500K+ charts during a peak-season retrospective review with embedded QA, second-level review, and transparent reporting throughout the engagement.

500K+

Charts Reviewed

100%

SLA Met

97%+

Accuracy

Embedded

QA Model
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Frequently Asked Questions

Retrospective, concurrent, prospective coding, HCC validation, audits, clinical documentation review, and QA.

We support applicable client requirements and current CMS-HCC methodologies.

Yes.

Multi-level QA, audits, calibration, education, and ongoing monitoring.

Yes. Client-specific guidelines and workflows are incorporated into training and production.

Yes, when supported by the medical record and client methodology.

We identify and document unsupported conditions for client review.

Yes.

Productivity, quality, HCC, RAF, trend, SLA, and operational reports.

Following discovery, access, onboarding, and calibration.

Yes. Our model is designed to scale.

Yes.

HIPAA-compliant processes and secure controls.

Yes.

Yes. ISO 9001 and ISO 27001.

Structured onboarding, client-specific training, calibration, and ongoing education.

Yes, when secure access and approved workflows are available.

Audit accuracy, QA scores, productivity, SLA performance, and trend analysis.

Coverage models can be customized.

Discovery, workflow alignment, access, training, calibration, launch, and governance.

Improve Risk Scores and Outcomes

Partner with JITMED to integrate scalable Risk Adjustment coding into your program delivery.

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