Surface Risk Opportunities Before Each Visit

CMS is signaling a shift away from retrospective risk adjustment and toward coding accuracy supported by encounter-based evidence. Although the proposed rule would eliminate extrapolated RADV recoveries, plans and providers will still need to capture and support risk at the point of care. Zus surfaces suspect and recapture conditions with linked clinical evidence before and during the encounter, helping teams document supported risk in real time

Zus connects to a national clinical data network covering 270M+ patients across 70,000+ provider sites. That means new diagnoses, specialist visits, labs, medications arrive in the patient record as they happen across the network.

Every suspect and recapture opportunity includes a narrative summary of the supporting evidence and direct links to the underlying documentation. Coders can quickly see what condition is being flagged, why it was identified, and review the supporting visit notes, CCDAs, PDFs, medications, and other source records behind the recommendation.

Zus integrates directly into EHR workflows via embeddable components. Coders and providers see risk capture opportunities inside their existing system. They don't need to switch to a separate tool, log into another portal, or export data.

Traditional risk adjustment vendors work after the fact, reviewing closed charts, running coding sweeps, and recovering what was missed months ago. Zus works prospectively. Clinical data refreshes continuously, suspect conditions surface before the encounter, and evidence is linked at the point of care.

Every suspect condition, every recapture recommendation, and every narrative summary links back to the original clinical document. That gives coders, compliance teams, and auditors a clear evidence trail.

Zus Recapture and Suspecting currently uses CMS-HCC V28. Other models can be supported, based on customer needs.