Simplify Human-Led Retrospective HCC Coding with Structured Workflow Control

RiskGen-Core streamlines coder, QA, and supervisor workflows—bringing structure, visibility, and compliance to every step of retrospective HCC coding through efficient chart allocation.

What is RiskGen-Core?

RiskGen-Core is a purpose-built platform for retrospective HCC coding, designed to solve operational inefficiencies and compliance risks in manual coding environments. It empowers coders, QA teams, and supervisors with intelligent task routing, live performance dashboards, and audit-ready documentation—all while ensuring CMS alignment and HIPAA compliance.

What Are the Challenges of HCC Coding?

Time-consuming allocation processes and coder backlogs

Inconsistent quality due to human error and coder variability

Compliance risks from missing documentation or justification gaps

Lack of real-time visibility into productivity and chart status

Overdependence on spreadsheets and static reports

Delayed turnaround times and inefficient task management

How RiskGen-Core Solves It?

RiskGen-Core transforms outdated manual coding with structure and real-time control.

Live Productivity Dashboards

Track coder performance, chart progress, and QA stats in real time with visual, filterable dashboards.

Centralized Role & Performance Tracking

Say goodbye to Excel. RiskGen-Core logs user roles, login activity, and task completion—all within the platform.

Single–Click Status Updates

Coders and reviewers can update chart statuses instantly, keeping everyone aligned.

Error Reduction & Coding Accuracy

Built-in ICD-10 validations and dashboards reduce mistakes and improve documentation consistency.

Audit-Ready Documentation

Every coding action, rationale, and review comment is timestamped and traceable—ensuring audit compliance.

Compliance & Risk Monitoring

RiskGen-Core flags high-risk charts or anomalies, aligning every action with CMS and internal compliance rules.

what RiskGen-Core offers?

Encipher Health supports the entire risk adjustment lifecycle with scalable, tech-enabled services.

Smart chart allocation by coder role, availability & specialization

Real-time performance tracking with live dashboards

Integrated workflow for coders, QAs, admins, and clients

Role-based access control with activity monitoring

Configurable chart status updates and notification logic

Exportable audit logs and CMS-aligned HCC mapping

Bulk upload capability for handling high chart volumes

Provider verification via NPI Registry integration

Platform Capabilities

Feature	Benefit
Role-based access	Ensures secure, controlled workflows and clear accountability.
Interactive productivity and quality dashboards	support real-time visibility and data-driven performance decisions.
Coder-wise educational error analytics	Strengthens consistency and continuous learning.
Bulk upload and easy reassignment	Bulk chart upload, Moveback (return) & Reallocate (reassign), Query & Rebuttal options enables seamless scaling for high-volume operations and accuracy.
NPI integration with provider directories	Ensures accurate provider identification and reduces claim rejection errors.
Financial summary and project-level reporting	Minimize manual consolidation and offer transparent visibility into reimbursement outcomes.

Frequently Asked Questions

What’s the difference between prospective, concurrent, and retrospective coding?

1. How is RiskGen-Core different from other HCC coding tools?

Unlike traditional tools that rely on static reports and manual allocations, RiskGen-Core offers real-time dashboards, task routing, built-in compliance checks, and full audit traceability—making it a smarter, centralized, and more scalable solution.

2. Can RiskGen-Core be customized for different client workflows?

3. Is RiskGen-Core compliant with CMS and HIPAA guidelines?

4. Does the platform support high-volume operations?

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