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Risk Adjustment Intelligence Platform

Intelligence that Powers Accurate Risk Adjustment

Wave delivers end-to-end data intelligence, compliance, and optimization solutions for health plans and hospital systems — capturing every condition, ensuring every dollar.

Risk Adjustment Dashboard
97.4%
HCC Coding Accuracy
↑ +4.2%
62%
Reduction in Manual Effort
↑ Improved
RADV
Audit-Ready Documentation
✓ Ready
100%
HIPAA Compliant Workflows
✓ Secure
+18.3% average RAF Score improvement
97%+
Coding Accuracy Rate
60%
Reduction in Operational Cost
2M+
Patient Records Processed
100%
HIPAA Compliant

Capture. Comply. Optimize.

Three pillars of intelligence that work together to power complete and accurate risk adjustment across your organization.

🔍

Capture

Comprehensive data intelligence that identifies and captures every chronic condition, HCC code, and clinical insight hidden in patient records.

  • NLP-driven chart mining and extraction
  • HCC code identification and validation
  • Retrospective and prospective coding
  • Computer-assisted coding (CAC) engine
🛡️

Comply

Built-in compliance frameworks that ensure every coded encounter meets CMS guidelines and is defensible in RADV audits.

  • RADV audit preparation and support
  • Real-time compliance monitoring
  • CMS risk adjustment validation
  • HIPAA-compliant data workflows
📈

Optimize

Advanced analytics and workflow automation that maximizes RAF scores, closes care gaps, and drives sustainable revenue performance.

  • RAF score modeling and optimization
  • Care gap identification and closure
  • Coder productivity dashboards
  • Revenue opportunity analytics

Purpose-Built for Risk Adjustment

Wave's intelligent platform covers the full spectrum — from data ingestion to audit-ready CMS submissions.

Data Intelligence Engine
Chart ingestion & parsingActive
NLP condition extraction97.4%
HCC code mappingValidated
Coder workflow queue1,284 charts
RAF score projection+18.3%

AI-Powered HCC Coding Platform

Our Computer-Assisted Coding engine uses natural language processing to scan medical records end-to-end — surfacing every chronic condition and HCC-relevant diagnosis, pre-highlighted for coders.

  • Processes structured and unstructured records
  • Pre-highlights clinically relevant passages
  • Reduces average chart review time by 60%
  • Supports both retrospective and prospective coding
See It in Action

Risk Adjustment Compliance Suite

Wave's compliance module ensures every diagnosis submission is defensible. From real-time coding validation to RADV audit support, we eliminate compliance risk at every step.

  • Automated RADV audit preparation
  • CMS-aligned coding validation rules
  • Overpayment identification and remediation
  • Complete audit trail and documentation
Learn More
Compliance Monitor
CMS submission validation✓ Pass
RADV audit readiness98.1%
Coding error flags3 flagged
Documentation completeness94%
Overpayment risk scoreLow

Optimization Analytics
RAF score vs benchmark+12.4%
Open care gaps identified847
Suspected conditions (HCC)312 unconfirmed
Coder productivity↑ 58%
Revenue opportunity$2.4M

Revenue & Performance Optimization

Turn risk adjustment data into actionable revenue intelligence. Wave's analytics layer identifies unsupported HCC codes, surfaces suspected conditions, and models financial impact of improved capture rates.

  • RAF score modeling and gap analysis
  • Suspected condition identification
  • Coder performance benchmarking
  • Payer and population-level reporting
Get a Revenue Assessment

From Chart to Clean Submission

Wave's end-to-end workflow automates the most labor-intensive steps — so your team focuses on clinical decisions, not paperwork.

01

Ingest

Securely ingest structured and unstructured medical records from any EHR, claim system, or document repository.

02

Analyze

Our NLP and AI engine scans every page — extracting chronic conditions, HCC-relevant diagnoses, and supporting clinical evidence.

03

Review

Pre-highlighted charts are routed to coders via an intuitive workflow interface, dramatically reducing time-per-chart.

04

Submit

Validated, compliant codes are prepared for CMS submission with a complete audit trail and RADV-ready documentation.

Built for a Regulated World

In healthcare, compliance isn't optional. Wave is engineered from the ground up with the regulatory rigor that health plans and providers require — from HIPAA to RADV to CMS risk adjustment standards.


Talk to Our Compliance Team
🔐

HIPAA Compliant

End-to-end encryption and role-based access controls across all data workflows

📋

RADV Ready

Audit-defensible documentation and complete submission audit trails

CMS Aligned

Current ICD-10 and HCC model compliance built into every workflow

🛡️

SOC 2 Standards

Enterprise-grade security controls and data governance frameworks

Built for Every Risk Adjustment Stakeholder

Whether you're a national health plan or a regional provider group, Wave scales to your risk adjustment needs.

🏥

Health Plans & Payers

Maximize RAF scores, reduce overpayment risk, and ensure CMS compliance across your entire member population with Wave's intelligent coding platform.

🏨

Hospital & Health Systems

Improve inpatient and outpatient documentation accuracy, capture missed diagnoses, and drive value-based care performance with tools your clinical teams will use.

🏢

Risk Adjustment Vendors

Embed Wave's intelligence layer into your own workflows to dramatically accelerate throughput, accuracy, and client outcomes at scale.

Ready to Transform Your Risk Adjustment Program?

Join health plans and hospital systems using Wave to capture more, comply better, and optimize revenue.

Or email us directly at info@wavehca.com