Capture what the chart supports. Nothing more, nothing less.
The same chart review that protects you in audit also finds supported conditions you missed, chronic conditions not yet recaptured, and documentation to fix with the provider.
Evidence
Quoted for Every Suspect
Per Member
Dollar Value
Drafted
Provider Queries
Coder
Reviews by Default
The problem
Why manual processes leak money and slow your business.
Supported conditions go unsubmitted
A condition documented in the chart but never coded is revenue the plan earned and never received.
Chronic conditions reset each year
Risk scores are rebuilt from each year's documentation, so a chronic condition that is not documented again drops out of next year's score.
Vague documentation does not count
Notes that mention a condition without specificity or a plan of care leave a coder unable to submit it, or exposed if they do.
The solution
How inferonIQ solves each pain point.
Suspect conditions
Conditions the chart supports but that were never submitted, each with the evidence quoted.
Recapture
Chronic conditions not yet documented this year, and members not yet seen, so outreach starts early.
Documentation gaps
Where the chart mentions a condition without the specificity or plan that would support it.
Provider queries
A compliant provider query drafted from the evidence for each gap, ready for the coder to send.
Valued in dollars
Every finding shows what it is worth using the member's MMR rate and segment.
Ask AI
Ask "which members have unsupported diabetes with complications?" in plain English and get the list with evidence.
Related capabilities
See what we find before you commit.
Read-only connection. We review a sample of your invoices, agreements and supplier spend, then hand back a findings report with specific figures. If there is nothing to recover, there is nothing to pay.