Capture Every Defensible HCC at the Point of Care.

Prospective risk adjustment identifies supported HCC opportunities before the encounter closes or before Medicare Advantage submission. QuickIntell combines EHR demographics, special-status flags, validated ICD-10 codes, and clinical note context so providers and reviewers can confirm conditions while the record is still current.

The module ingests patient demographics, the encounter ICD-10 set, prior-year HCC history, and scribe or coding context. It maps ICD-10 codes to HCCs, surfaces recapture gaps and vague-code prompts, and shows the supporting source excerpt so clinicians can accept, clarify, or reject suggestions.

Suggested HCCs move through a review detail view with source ICD-10 codes, confidence, hierarchy notes, and the supporting note excerpt. Reviewers must accept, modify, or reject each suggestion, and insufficient Monitor, Evaluate, Assess, or Treat documentation is rejected with a reason and audit trail.

CMS-HCC v28 is the current CMS risk adjustment model that changes how many diagnoses map and weight into RAF. QuickIntell supports v22, v24, and v28 crosswalk visibility, defaults to cms_hcc_v28 for 2026 when appropriate, and applies the correct model, coefficient, hierarchy, and normalization factor by payment year.

QuickIntell treats dual-mapped ICD-10 codes as multi-HCC opportunities instead of stopping at the first match. For example, E11.22 can surface both mapped HCC categories, then hierarchy logic, segment rules, and reviewer sign-off determine what counts in the finalized RAF.

Yes. After approval, the finalized HCC list and RAF score write back to the EHR as a structured risk profile. With OpenEMR, recapture outreach can also write back as a care-management flag visible on the patient banner, and the same integration pattern supports other connected EHRs.

Every captured HCC keeps its source encounter, ICD-10 code, model version, hierarchy decision, reviewer, and timestamp. Rejections and reversals are also logged, and audit packets can be exported from Analytics so teams can respond without rebuilding evidence from spreadsheets.

QuickIntell reads ESRD status from the patient demographic and EHR data, then uses the ESRD segment and the appropriate ESRD-HCC model when the patient qualifies. Segment changes, such as a mid-year dialysis start, are reflected in the job log and remain auditable.

The manual baseline is 70-75% typical recapture, with a 90%+ target for mature programs. For a 5,000-life Medicare Advantage panel, QuickIntell's 90-day operating target is $1.4M-$2.6M in annualized incremental revenue, depending on panel acuity, documentation quality, and workflow adoption.

Single-patient RAF jobs usually complete in seconds once EHR integration, permissions, model settings, and reviewer queues are configured. Most teams start with connected EHR demographics, validated ICD-10 ingestion, human review routing, and Analytics exports before enabling direct CMS submission.