NewBecker's 2026 Top RCM · Inc. 5000 · Dallas 100
A behavioral health platform grew collections by $2.4M / year with Plutus Health →
SOC 2 Type 2 · HIPAA · BHCOE · CASP
Every undocumented Hierarchical Condition Category (HCC) lowers future reimbursement. Plutus Health combines Medical Coding AI operating in HCC mode with AAPC-certified CRC coders to identify missed HCC conditions, improve Risk Adjustment Factor (RAF) accuracy, strengthen CMS compliance, and support complete Hierarchical Condition Category coding across Medicare Advantage, ACO, and health plan populations.
Get Your Free RCM Assessment →Explore All 25 AI Agents →Certified CRC coders review medical records, assign accurate HCC ICD-10-CM codes, and ensure every reportable condition meets CMS risk adjustment requirements.
We abstract chronic conditions from physician documentation, laboratory results, imaging, hospital records, and encounter documentation using MEAT and TAMPER validation.
We identify missed HCC opportunities to improve the accuracy of Risk Adjustment Factors while maintaining coding compliance and documentation integrity.
Every calendar year, chronic conditions must be documented again. We monitor continuity to prevent HCC loss and future reimbursement declines.
Our documentation reviews strengthen audit readiness, validate submitted HCCs, and prepare organizations for CMS and RADV validation activities.
OlympusAI measures HCC capture performance, RAF trends, provider variation, coding quality, and documentation gaps across your entire population.
OlympusAI identifies potential HCC conditions, validates ICD-10-CM documentation, detects missing diagnoses, and prioritizes high-value charts for coder review.
Population-level analytics identify RAF leakage, undocumented chronic conditions, provider documentation variation, and recapture opportunities before submission deadlines.
Every coded condition is validated against CMS guidelines, HCC mapping logic, documentation requirements, and audit rules before submission.
OlympusAI analyzes patient populations to identify undocumented chronic conditions, incomplete medical records, and high-value RAF improvement opportunities before coding begins.
Certified CRC coders validate physician documentation, abstract HCC conditions, assign compliant ICD-10-CM codes, and verify every diagnosis satisfies MEAT or TAMPER requirements.
Every submission is reviewed for coding accuracy, documentation completeness, CMS compliance, and annual HCC continuity before final reporting to Medicare Advantage or health plans.
Our 30-day HCC coding assessment evaluates RAF performance, HCC capture opportunities, documentation quality, CMS compliance, and Risk Adjustment coding accuracy to help you develop a measurable roadmap for revenue improvement.
