D 4 Pro – AI Prospective Risk Adjustment

Prospective Risk Adjustment - with real-time HCC capture in the provider workflow

D4Pro is a prospective and concurrent coding solution that operates natively within the provider’s EHR — surfacing HCCs that must be addressed during the patient encounter. As a leader in digital healthcare, D4Pro delivers clear, actionable guidance by processing complex medical information to identify:
• Previously coded (persisting) HCCs requiring revalidation
• Under-coded conditions
• Uncoded HCC gaps

All recommended codes are supported by evidence and subject to review and approval by the health plan — ensuring clinical integrity and compliance.

Provide pre-visit and in-visit recommendations that are evidence linked and MEAT-aware. Empower providers to act quickly while ensuring coding stays defensible and risk score accuracy improves.

D4H's prospective risk adjustment solution is built for payers, providers, and auditors operating in high-compliance, value-based care environments.

Performance Capabilities

99%

Coding Accuracy

+99% accuracy for mapping diagnoses codes to the correct HCC, driving higher reimbursement, fewer deletes, and significantly improved CMS submissions.

Seamless EHR Workflow

Automate risk gap closure directly in the provider's workflow, surfacing HCC that must be addressed. Flexible EHR integration - with the EHR's that your providers use. We collaborate with clients to prioritize where you get the best return on your investment

Expand at Scale

Unlimited scalability for millions of charts. Deploy in your private cloud—AWS, Azure, or Google—and add more GPUs as needed. Truly unlimited processing power, under your control.

Technology Built for Enterprise Scale

Native EHR Workflow

"Runs natively in the Provider's EHR: providing concise, actionable, real-time coding guidance at the point of care".

Evidence-linked + MEAT-aware

Clear “why” and documentation signals to reduce noise and minimize provider friction.

Deployed inside your environment

Cloud/VPC or on-prem options ensure PHI stays under your control at all times.

Built for Trust and Accuracy

D4H is designed for environments where compliance, precision and transparency are non-negotiable.

More captured value

Find supported, under coded HCCs with evidence packaged for action.

Less wasted review time

Page-level evidence and provenance reduce "PDF hunting" and speed decisions.

Stronger audit posture

MEAT-aware findings help prevent overcoding and improve RADV readiness.

Higher trust output

Every recommendation ships with "why", so reviewers can validate in seconds.

Interoperability

Designed to work with any EHR, from the most prevalent platforms in the industry like Epic, Athenahealth to the smaller vendor platforms.

Deployed inside your environment

Runs in your cloud/VPC or on-prem to keep PHI safe under your control. No external data egress required.

Identify & Capture HCC Opportunities Before Submission

Automate data capture, streamline validation, and maintain compliant submissions with the same guided workflow.

Data Extraction

Automated data capture from the source systems that feed pre-submission review.

  • EHR & Clinical Systems
  • Pathology Reports
  • Labs & Imaging

Automation & Submission

Streamline abstracting, validate data quality, and keep submissions compliant.

  • AI-powered abstracting and standardized workflows
  • Data quality checks for submission readiness
  • NAACCR/state reporting, automated submission, and audit trails

Monitoring

Maintain visibility, compliance, and operational follow-through after submission.

  • Real-time Dashboards
  • Compliance Tracking
  • Regulatory Updates

Outputs Built for Scale

Every suggestion is packaged with the context and evidence required for immediate action.

MEAT Evidence

Explicit linkage to Monitoring, Evaluation, Assessment, or Treatment evidence within the clinical record.

Provenance

Direct deep-links to the original note text, date of encounter, and source system for total traceability.

Prioritization

Customized confidence and impact thresholds tailored to fit your organization's unique risk profile.

High signal, low noise, so clinicians don't tune it out

Prospective success is adoption. Adoption requires precision, brevity, and defensibility.

MEAT-aware recommendations

Every recommendation is supported by documented Monitoring, Evaluation, Assessment, or Treatment evidence.

Evidence provenance

Complete note/date/source traceability enabling clinicians to validate quickly and confidently.

Prioritization + thresholds

Fit your standards and risk tolerance with customizable prioritization and confidence thresholds.

Deployment control

Deploy on cloud, VPC, or on-premises—PHI stays under your control with flexible deployment options.

Get Started

Ready to operationalize prospective risk adjustment?