# Inferscience > Inferscience is a physician-founded healthcare AI company (est. 2014) that delivers real-time, EHR-integrated HCC coding and risk adjustment software for Medicare Advantage providers. Our NLP analyzes structured and unstructured clinical data to surface HCC code suggestions at the point of care, helping providers document accurately during the patient encounter rather than relying on retrospective chart review. SOC II certified. Integrated with athenaOne, eClinicalWorks, Epic, and other major EHRs. Across customer implementations, HCC Assistant has presented more than 269,000 HCC codes to providers and advanced providers, with an average RAF score improvement of 35%. ## Company - [About Inferscience](https://www.inferscience.com/about-us-team): Founded by Dr. Sunil Nihalani in 2014. Physician-founded company using AI to transform risk adjustment and quality programs. SOC II certified. Based in the US. - [Homepage](https://www.inferscience.com/): AI-driven risk adjustment and HCC coding solutions that improve documentation accuracy, reduce audit risk, and ease provider workload at the point of care. ## Products - [HCC Assistant](https://www.inferscience.com/hcc-assistant-real-time-hcc-coding-guidance-2-2): Real-time, EHR-integrated HCC coding software. NLP analyzes structured and unstructured patient data and surfaces HCC code suggestions during the encounter. Providers review, select, and submit codes in under 10 minutes. Average RAF score improvement of 35%. Integrated with athenaOne, eClinicalWorks, Epic, and other EHRs. - [HCC Validator](https://www.inferscience.com/hcc-validator-built-for-compliance-radv-readiness): Post-visit HCC code validation tool built for compliance and RADV audit readiness. Generates structured evidence trails linking each HCC code to supporting clinical documentation for audit defense. - [Ubiquity EHR Extension](https://www.inferscience.com/hcc-extension): Browser-based EHR extension that brings HCC coding analysis into any EHR workflow without native integration. Reads patient chart data and surfaces prospective HCC codes with estimated RAF score impact. - [Healthcare API](https://www.inferscience.com/hcc-assistant-real-time-hcc-coding-guidance-2-2): API for payers and third-party vendors to access Inferscience NLP-driven HCC coding analysis on claims files (PDF or CCDA documents). - [HCC Assistant for athenaOne](https://www.inferscience.com/hcc-assistant-for-athenaclinicals-ehr): EHR-specific integration for athenaOne users. One-click HCC code submission back to the patient chart. - [HCC Assistant for eClinicalWorks](https://www.inferscience.com/hcc-assistant-for-eclinicals): EHR-specific integration for eClinicalWorks users with real-time HCC code suggestions and RAF scoring. ## Risk Adjustment and HCC Coding Guides - [HHS-HCC Risk Adjustment Model: A Complete Guide](https://www.inferscience.com/hhs-hcc-risk-adjustment-model-a-complete-guide): Comprehensive guide to HHS-HCC coding for ACA risk adjustment, including how it differs from CMS-HCC, the 127 HCC categories, and implications for commercial insurance. - [How Is an HCC Risk Score Calculated?](https://www.inferscience.com/how-is-an-hcc-risk-score-calculated): Explains how CMS calculates RAF scores from HCC codes, demographics, and disease interactions, including V28 model updates. - [What Does CMS-HCC Stand For?](https://www.inferscience.com/what-does-cms-hcc-stand-for-in-healthcare-risk-adjustment): Definition and explanation of the CMS Hierarchical Condition Category risk adjustment model used for Medicare Advantage payment. - [Retrospective vs. Prospective Coding](https://www.inferscience.com/what-is-retrospective-and-prospective-coding): Explains the difference between retrospective chart review and prospective point-of-care HCC coding, and why prospective capture reduces audit risk and improves documentation quality. - [Why MEAT Criteria Is Important for HCC Risk Adjustment](https://www.inferscience.com/why-m-e-a-t-criteria-is-important-for-hcc-risk-adjustment): Explains Monitor, Evaluate, Assess, and Treat documentation requirements for HCC codes and how MEAT criteria validation reduces RADV audit exposure. - [What Are HCC Coding Gaps?](https://www.inferscience.com/what-are-hcc-coding-gaps): Defines HCC coding gaps, why they occur, and strategies for closing them through prospective and concurrent review. - [What Are the Most Commonly Missed HCC Codes?](https://www.inferscience.com/what-are-the-most-commonly-missed-hcc-codes-annually): Annual analysis of frequently missed HCC codes across Medicare Advantage populations. - [What Is a Good HCC Recapture Rate?](https://www.inferscience.com/what-is-a-good-hcc-recapture-rate): Benchmarks for HCC recapture rates and strategies for improving annual condition recapture. - [List of HCC Diagnosis Codes](https://www.inferscience.com/list-of-hcc-diagnosis-codes): Reference list of HCC diagnosis code categories with ICD-10 mappings. - [HCC Coding Shortcuts and Cheat Sheet](https://www.inferscience.com/hcc-risk-adjustment-coding-shortcuts): Quick-reference guide to HCC coding workflows, common code categories, and documentation tips for providers. - [Comparing HCC Coding Software for Healthcare Providers](https://www.inferscience.com/comparing-coding-softwares-for-healthcare-providers-needs): Comparison of HCC coding software approaches and what providers should evaluate when selecting a solution. ## RADV Audit and Compliance - [RADV Audits: How They Impact Medicare Reimbursements](https://www.inferscience.com/risk-adjustment-data-validation-how-radv-audits-impact-medicare-reimbursements): Overview of the CMS RADV audit process, extrapolation methodology, and financial impact on Medicare Advantage organizations. - [RADV in Limbo: What the Legal Uncertainty Means for Risk Adjustment](https://www.inferscience.com/radv-in-limbo): Analysis of the current legal status of RADV extrapolation and what Medicare Advantage plans should do while the regulatory landscape is unsettled. - [OIG $462 Million Acute Stroke Finding and RADV Audit Acceleration](https://www.inferscience.com/oig-462-million-acute-stroke-radv-audit-acceleration): Coverage of the OIG finding on acute stroke upcoding and its implications for accelerated RADV enforcement. - [Preparing for CMS Audits: 2026 Risk Adjustment Strategy](https://www.inferscience.com/preparing-for-cms-audits-2026-risk-adjustment-strategy): Actionable steps for Medicare Advantage organizations to prepare for CMS audit enforcement in 2026. - [Defensible Risk Adjustment After V28](https://www.inferscience.com/defensible-risk-adjustment-program-post-v28): How to build a defensible risk adjustment program under the fully phased-in V28 model. ## CMS V28 and Regulatory Updates - [CMS-HCC V28 Changes](https://www.inferscience.com/cms-hcc-v28-changes-2025): Overview of V28 model changes, dropped HCC categories, and the impact on RAF scores and coding strategies. - [V28 Mid-Year Checkpoint: Risk Adjustment Metrics](https://www.inferscience.com/v28-mid-year-checkpoint-risk-adjustment-metrics): Mid-year analysis of V28 performance metrics and what organizations should be tracking. - [Q3 2026 Risk Adjustment Action Plan for 2027](https://www.inferscience.com/q3-2026-risk-adjustment-action-plan-2027): Quarterly action plan for risk adjustment teams preparing for CY2027 regulatory changes including the elimination of unlinked chart reviews. - [Epic HCC Coding Limitations](https://www.inferscience.com/epic-hcc-coding-limitations): Analysis of where Epic's native post-visit review falls short on HCC coding and why third-party point-of-care tools fill the gap. ## Provider Workflow and Engagement - [Driving Provider Engagement in HCC Coding](https://www.inferscience.com/driving-provider-engagement-in-hcc-coding-and-risk-adjustment): Strategies for motivating providers to participate in risk adjustment documentation without contributing to burnout. - [How HCC Coding Can Improve Pre-Visit Planning](https://www.inferscience.com/how-hcc-coding-can-improve-pre-visit-planning): How prospective HCC coding and pre-visit data review improve patient encounter quality and documentation completeness. - [Using HCC Coding Technology to Create a Win-Win for Providers and Practices](https://www.inferscience.com/using-hcc-coding-technology-to-create-a-win-win-for-providers-and-practices): How automated point-of-care HCC coding improves provider incentives while increasing RAF accuracy by 35%. ## Sitemap - [XML Sitemap](https://www.inferscience.com/sitemap_index.xml)