UCG SOLUTIONS
Support complete, defensible risk-adjustment documentation and coding workflows.
Coding and documentation support for HCC and risk-adjustment workflows where applicable to the organization and engagement. Reviews are grounded in source documentation, current program rules and qualified human oversight.
Scope of support
- Documentation-to-code review
- HCC / risk-adjustment coding support where applicable
- Suspect and recapture workflow review
- Coding QA and audit support
- Provider education and feedback workflows
- Risk and exception reporting
Common risks and triggers
- Unsupported or incomplete documentation
- Missed recapture opportunities
- Coding inconsistency
- Audit exposure
- Workflow gaps between care and coding teams
HOW THE WORK MOVES
Follow this capability through its operating steps.
Select each stage to inspect the task, the issue to watch, an example action and the accountable reviewer.
WORKFLOW EXPLORER
Documentation review to validated risk record
A documentation-centered process with qualified coding and compliance review; applicability varies by program.
SELECTED STAGE
Program context
Applicable program, period and documentation sources are identified.
Illustrative operating sequence. Final responsibilities, payer rules and automation scope are confirmed for each engagement.
Organizations served
- Hospitals & Health Systems
- Physician Groups
- Primary Care / Family Medicine
- Healthcare Organizations
INTELLIA relevance
UCG INTELLIA™ supports operational visibility, prioritization and workflow automation across revenue-cycle work, with review roles defined for each process.
- Denial Intelligence: Detect patterns, surface likely root causes, prioritize work and connect recovery findings back to prevention.
- A/R Intelligence: Segment accounts by age, value, payer, denial status and recovery potential.
- Coding Intelligence: Support documentation and coding review, QA prioritization and coding-risk visibility with human review.
- Eligibility Intelligence: Surface coverage and eligibility issues early in the revenue cycle.
- Revenue Analytics: Connect operational and financial KPIs into role-relevant views.
Related services
Discuss your workflow with UCG.
Share the revenue-cycle issue, operational priority or payer challenge you are working through.
Review Risk Adjustment Workflow