Risk Adjustment Software with AI

 Capture more accurate RAF scores and improve HCC coding productivity by up to 10x—right at the point of care

ForeSee ESP® risk adjustment software brings real-time risk adjustment insights directly into your workflow by analyzing the EHR data and clinical notes you already have. With AI-powered disease detection and Natural Language Processing, ForeSee’s risk adjustment tool helps you code accurately at the point of care—saving time, and supporting better clinical decisions. With AI designed to support your expertise, ForeSee improves documentation without adding burden.

SAVE TIME AND MONEY

Get it right the first time

Prospective decision support and retrospective review options ensure your Medicare risk adjustment coding is evidence-based and accurate. Improve your compliance, reduce work during sweep timeframes, and eliminate clerical bottlenecks by coding correctly at the point of care. Make life easier with clinical decision support at the time of the encounter, or before. Because it always feels great to do something right the first time.

Keep it simple

Works the way you think

We know you think in terms of disease and not codes or risk adjustment categories, so our proprietary disease detection algorithm thinks the same way. Once a disease is detected, the coding and RAF scoring is easy. You get the recommended code for the disease and our HCC coding tool matches it to the risk adjustment category for scoring. Isn’t it nice when you can keep things simple?

it’s all yours

Designed the way you want

Developed by physicians and coders just like you, ForeSee ESP is cloud-based, designed to work on any device, and integrate seamlessly with your EHR. Simplify confusing codes (SNOMED to ICD10) and process your patient data in just about any format, including the latest FHIR APIs. Get decision support and using ForeSee’s exclusive InstaVu® feature, click links tracking the evidence back to the patient chart, including data extracted from text (PDF) notes. All presented in a streamlined, easy to understand format. Just the way you like it.

Case Study

Learn how this ForeSee client's strong performance led to its acquisition, resulting in a year-long EHR transition that temporarily paused services. Explore the impact on RAF scores before and after the transition.

our team is your team

We learn by listening to you

Our Executive Chairman and CEO are both board certified physicians and understand complex workflows. In our last venture, we listened carefully to the needs of healthcare professionals, and invented the first cloud-based EHR with touch technology on the iPad. It simplified the way providers interact with their patient’s health record and was top-rated by Medical Economics Magazine. This time around, you get the benefits of valuable lessons we’ve learned, our team knows how to transform complex workflows into a risk adjustment tool with a simple interface.

PROVIDERS

Get the data you need

We’ve entered an era of information overload—where the sheer volume of patient data makes it nearly impossible for physicians to manually review years of medical records to assess a patient’s current disease burden or risk score. That’s where ForeSee ESP®, our advanced risk adjustment software, comes in. This powerful risk adjustment tool leverages AI-driven natural language processing to scan, extract, and surface clinically relevant events from across a patient’s longitudinal record—automatically linking findings to the original source documentation.

Instead of digging through endless PDFs, discharge summaries, and specialist notes, providers receive real-time, encounter-ready insights directly within their workflow. Clinical decision support is continuously updated, ensuring the most accurate and timely information is available at the exact moment of care. And when it’s time to select the appropriate ICD-10 code, ForeSee ESP® simplifies the process by suggesting the most likely, clinically valid codes linked to the diagnoses being documented. This not only saves time—it improves coding precision, compliance, and risk score accuracy, helping care teams focus more on patients and less on paperwork.

CODERS

Capture complete diagnoses

If you're a coding expert, you've likely encountered a wide variety of workflows designed to support HCC risk adjustment coding. At ForeSee Medical, we understand that no two organizations are alike—which is why our risk adjustment software is built to flexibly support both prospective and retrospective coding models.

For organizations adopting a prospective workflow, our risk adjustment tool empowers coders to collaborate with providers before the patient visit. Coders can review historical data and suspected conditions, then share recommendations directly with physicians using built-in communication tools that streamline the exchange of information. This ensures that documentation opportunities are not overlooked during the patient encounter.

On the retrospective side, our platform includes robust worklists and reporting features that help coders review encounters after the visit to identify any missed HCC opportunities. By combining intelligent analytics with flexible workflow support, our risk adjustment software ensures that your team captures accurate and complete documentation—whether before or after the visit—while enhancing compliance and optimizing RAF scores.

Whether you're managing prospective reviews, retrospective audits, or a hybrid approach, our risk adjustment tool helps maximize efficiency, accuracy, and collaboration at every stage of the coding process.

ADMINISTRATORS

Allocate proper resources

Think of the time, money, and resources your organization spends reworking tasks when risk adjustment isn’t done accurately the first time—right at the point of care. Every missed diagnosis, unclear documentation, or outdated code can lead to costly delays, follow-up requests, and excessive back-and-forth with coders and health plans. That’s where a reliable risk adjustment software solution makes all the difference.

ForeSee ESP® includes a powerful Risk Adjustment Analyzer tool that enables you to monitor your medical group’s average patient risk score in real time and compare it against projected benchmarks. This intelligent risk adjustment tool helps identify gaps, detect anomalies, and validate that your coding reflects the true disease burden of your population.

With built-in visibility into risk score performance by provider or subgroup, ForeSee ESP® empowers leadership to allocate resources strategically—ensuring care teams serving the most complex patients get the support they need. By leveraging advanced risk adjustment software at the point of care, you can reduce coding ambiguity, minimize downstream inefficiencies, and improve financial performance across your value-based care contracts.

QUALITY TEAMS

Improve health accuracy

Patients are more informed than ever—and now many carry an abbreviated version of their medical record right on their mobile devices. As healthcare evolves, it’s essential that the disease lists patients see truly reflect their current clinical status. That’s where accurate, real-time documentation becomes more than just good practice—it becomes a cornerstone of trust and transparency.

ForeSee’s risk adjustment software helps providers deliver clinically appropriate and up-to-date documentation by integrating advanced clinical decision support at the point of care. Our risk adjustment tool doesn’t just surface new, codable conditions—it also flags inaccurate or outdated codes that no longer reflect the patient’s health status. This dual approach enhances coding accuracy and reduces audit risk by ensuring that your coding process is defensible and compliant with CMS standards.

To support audit readiness, our Delete Suspects report highlights diagnoses that have been previously captured but lack current clinical evidence, helping provider groups proactively remove codes that shouldn’t be recaptured. It’s not just about identifying what to add—it’s also about knowing what to leave out. In today’s value-based care environment, risk adjustment software must do more than automate—it must ensure integrity at every step.