AI-Powered HEDIS Coding Solutions to Maximize Compliance

Is your healthcare organization struggling to meet HEDIS performance benchmarks?

With quality measures crucial for both reimbursement and patient care, accurate Healthcare Effectiveness Data and Information Set (HEDIS) abstraction and HCC documentation are vital.

Our expert certified coders work with MedGenX, our proprietary AI powered medical coding platform powered by DeepKnit AI to streamline HEDIS compliance. Our AI‑driven process improves HCC coding by accurately capturing risk‑adjustment data, ensuring proper documentation, and supporting compliance for value‑based care programs

By combining advanced natural language processing with automated code mapping, our AI-assisted HEDIS coding and quality reporting support helps hospitals and clinics close care gaps and improve quality scores. We also provide HEDIS chart abstraction services for health plans that support precise medical record review, efficient data collection, and improved HEDIS performance.

Our AI driven HEDIS coding solution automates data capture and ensures accurate code mapping, while identifying care gaps before they impact scores.

This simplifies compliance for health plans and providers.

Key Benefits:

• Automated Data Capture: Extracts relevant diagnoses, procedures, labs, and screenings directly from clinical notes and EHRs.
• Accurate Code Mapping: Translates documentation into standardized codes (ICD‑10, CPT, LOINC, SNOMED) aligned with HEDIS measures.
• Measure Validation: Confirms numerator/denominator compliance and flags missing documentation or overdue care.
• Performance Insights: Generates dashboards and reports to support NCQA submissions and track quality outcomes.
• Efficiency & Accuracy: Reduces manual chart review, minimizes coding errors, and accelerates reporting.

With AI‑driven HEDIS coding, organizations can streamline compliance, improve patient care, and strengthen their quality ratings.

HEDIS abstraction is the process of capturing patient data based on HEDIS measures, ensuring healthcare organizations report quality metrics accurately and remain compliant.

Our AI‑enabled platform, supported by experienced clinical documentation specialists, identifies chronic conditions, comorbidities, and risk factors that impact patient care. By combining intelligent automation with expert oversight, we ensure all relevant diagnoses are documented and coded to meet CMS and HEDIS requirements.

Our services include:

• Medical Record Review: AI scans patient charts to surface key data points.
• Data Extraction: Relevant diagnoses, labs, and screenings are captured efficiently.
• Accurate Coding: Codes are assigned with precision for consistent reporting.
• Compliance Audits: Automated checks validate accuracy and adherence to CMS guidelines.

Our focused AI‑driven HEDIS abstraction support helps healthcare organizations streamline workflows, reduce errors, and strengthen quality performance.

Why Choose OSI as Your Medical Coding Outsourcing Partner

• Project manager: Dedicated project manager to oversee your account
• Extensive experience: Expert support to maximize reimbursement and minimize denials
• Cost savings: Achieve 30-40% savings on overhead costs
• Experience flexibility: No long-term contracts or upfront fees
• Rigorous quality assurance: AI and human-in-the-loop validation to ensure accurate documentation and coding
• Fast turnaround: Quick processing times, timely submissions and reimbursements, powered by MedGenX
• Specialty-specific expertise: Tailored coding solutions across various specialties
• Stay updated on regulations: Meet compliance requirements
• Implement best practices: Optimize your code assignment processes
• Seamless integration, smooth workflow: We operate as an extension of your practice

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