HCC Compliance Validator

JSON twin: https://www.healthaidb.com/software/hcc-compliance-validator.json

Company Name

Ambience Healthcare

Product URL

https://www.ambiencehealthcare.com/products

Company URL

https://www.ambiencehealthcare.com

Categories

• clinical Care
• administrative Operations
• patient Facing
• diagnostic Support
• Clinical
• Administrative
• Diagnostic

Summary

HCC Compliance Validator is a real-time tool by Ambience Healthcare that ensures clinician-selected diagnoses meet CMS documentation standards, identifying and addressing gaps during patient encounters to prepare audit-ready notes.

Description

HCC Compliance Validator is a real-time tool by Ambience Healthcare that checks whether clinician-selected diagnoses are fully substantiated according to CMS documentation standards. It identifies gaps in documentation for clinicians to address before notes are completed, helping clinicians prepare audit-ready notes. Unlike traditional retrospective reviews, Ambience empowers clinicians to resolve compliance issues during the encounter, eliminating the potential for disruptive downstream queries and protecting health systems from disallowance. The tool ensures that hierarchical condition categories (HCCs) are fully substantiated in line with Monitor, Evaluate, Assess, Treat (MEAT) criteria. The HCC Compliance Validator is integrated within Epic, athenahealth, and other EMR systems, allowing seamless workflow integration. It has been deployed at health systems across the country, including John Muir Health, UCSF Health, St. Luke’s Health System, and Memorial Hermann Health System, among others, enabling clinicians to focus more on patients and less on administrative tasks. The tool is scalable across multiple EHRs, ensuring broad applicability across different healthcare settings. It is designed to work seamlessly within existing clinical workflows, reducing the need for manual interventions and improving overall efficiency. The HCC Compliance Validator is part of Ambience Healthcare's broader suite of AI-powered tools aimed at enhancing clinical documentation and compliance.

Api Available

unknown

Certifications

• FDA 510(k)
• CE/MDR
• ONC
• ISO 27001

Company Founding

2019

Company Offices

• United States

Compliance

• HIPAA
• HITECH
• SOC 2
• ISO 27001

Customers

• Houston Methodist
• St. Luke's Health System
• Alpine Physician Partners
• Eventus WholeHealth
• Cleveland Clinic
• Onvida Health
• John Muir Health
• Ardent Health-affiliate Utica Park Clinic

Data Residency

US/EU regions

Data Standards

• FHIR
• HL7 v2
• DICOM
• SNOMED
• ICD-10

Deployment Model

• SaaS

Features

• Real-time HCC compliance validation
• Integration with Epic and athenahealth EHR systems
• Flags unsupported or incomplete diagnoses during patient encounters
• Ensures documentation meets CMS standards and MEAT criteria
• Reduces audit risk by addressing compliance issues at the point of care
• Improves documentation integrity and coding accuracy
• Supports over 100 medical specialties and subspecialties
• Provides real-time prompts to clinicians for documentation gaps
• Enhances clinician workflow by integrating directly into EHRs
• Offers coding-aware ambient AI scribing capabilities

Id

SW2648

Integration Partners

• Epic
• athenahealth
• Cerner
• AdvancedMD
• eClinicalWorks
• Elation
• Microsoft Azure
• Microsoft AppSource

Integrations

• Epic
• athenahealth

Languages Supported

• English
• Spanish

Last Updated

2025-10-11

License

commercial

Market Segment

• enterprise
• smb

Optional Modules

Os Platforms

• Web

Pricing Details

contact vendor

Pricing Model

subscription

Privacy Features

• BAA available
• consent mgmt
• anonymization
• data minimization

Product Code

SW2648

Product Name

HCC Compliance Validator

Ratings

• 97.7% customer satisfaction (KLAS Research)

Regions Available

• United States

Related Urls

Release Year

2020

Security Features

• Encryption
• RBAC
• SSO/SAML
• audit logs
• 2FA

Specialties

• General Medicine
• Cardiology
• Dermatology
• Oncology
• Pulmonology
• Rheumatology
• Hematology
• Family Medicine
• Otolaryngology
• Nephrology
• Gastroenterology
• Physical Medicine And Rehabilitation
• Internal Medicine
• Neurology
• Endocrinology
• Geriatrics
• Urology
• Psychiatry
• Urgent Care

Support Channels

• email
• phone
• chat
• ticketing

System Requirements

Target Users

• clinicians
• nurses
• admins

Training Options

• documentation
• webinars
• live_online

Type

product

User Reviews

• I no longer exist in the perpetual dread of keeping up with documentation, and I have more mental clarity and presence with others at work and home.

Version

1.0

Alternatives

See related products

Canonical JSON

{
  "product_name": "HCC Compliance Validator",
  "company_name": "Ambience Healthcare",
  "product_url": "https://www.ambiencehealthcare.com/products",
  "company_url": "https://www.ambiencehealthcare.com",
  "related_urls": [],
  "product_code": "SW2648",
  "summary": "HCC Compliance Validator is a real-time tool by Ambience Healthcare that ensures clinician-selected diagnoses meet CMS documentation standards, identifying and addressing gaps during patient encounters to prepare audit-ready notes.",
  "description": "HCC Compliance Validator is a real-time tool by Ambience Healthcare that checks whether clinician-selected diagnoses are fully substantiated according to CMS documentation standards. It identifies gaps in documentation for clinicians to address before notes are completed, helping clinicians prepare audit-ready notes. Unlike traditional retrospective reviews, Ambience empowers clinicians to resolve compliance issues during the encounter, eliminating the potential for disruptive downstream queries and protecting health systems from disallowance. The tool ensures that hierarchical condition categories (HCCs) are fully substantiated in line with Monitor, Evaluate, Assess, Treat (MEAT) criteria. The HCC Compliance Validator is integrated within Epic, athenahealth, and other EMR systems, allowing seamless workflow integration. It has been deployed at health systems across the country, including John Muir Health, UCSF Health, St. Luke’s Health System, and Memorial Hermann Health System, among others, enabling clinicians to focus more on patients and less on administrative tasks. The tool is scalable across multiple EHRs, ensuring broad applicability across different healthcare settings. It is designed to work seamlessly within existing clinical workflows, reducing the need for manual interventions and improving overall efficiency. The HCC Compliance Validator is part of Ambience Healthcare's broader suite of AI-powered tools aimed at enhancing clinical documentation and compliance.",
  "categories": [
    "clinical Care",
    "administrative Operations",
    "patient Facing",
    "diagnostic Support",
    "Clinical",
    "Administrative",
    "Patient-facing",
    "Diagnostic"
  ],
  "market_segment": [
    "enterprise",
    "smb"
  ],
  "target_users": [
    "clinicians",
    "nurses",
    "admins"
  ],
  "specialties": [
    "General Medicine",
    "Cardiology",
    "Dermatology",
    "Oncology",
    "Pulmonology",
    "Rheumatology",
    "Hematology",
    "Family Medicine",
    "Otolaryngology",
    "Nephrology",
    "Gastroenterology",
    "Physical Medicine And Rehabilitation",
    "Internal Medicine",
    "Neurology",
    "Endocrinology",
    "Geriatrics",
    "Urology",
    "Psychiatry",
    "Urgent Care"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English",
    "Spanish"
  ],
  "pricing_model": "subscription",
  "pricing_details": "contact vendor",
  "license": "commercial",
  "company_offices": [
    "United States"
  ],
  "company_founding": "2019",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web"
  ],
  "features": [
    "Real-time HCC compliance validation",
    "Integration with Epic and athenahealth EHR systems",
    "Flags unsupported or incomplete diagnoses during patient encounters",
    "Ensures documentation meets CMS standards and MEAT criteria",
    "Reduces audit risk by addressing compliance issues at the point of care",
    "Improves documentation integrity and coding accuracy",
    "Supports over 100 medical specialties and subspecialties",
    "Provides real-time prompts to clinicians for documentation gaps",
    "Enhances clinician workflow by integrating directly into EHRs",
    "Offers coding-aware ambient AI scribing capabilities"
  ],
  "optional_modules": [],
  "integrations": [
    "Epic",
    "athenahealth"
  ],
  "data_standards": [
    "FHIR",
    "HL7 v2",
    "DICOM",
    "SNOMED",
    "ICD-10"
  ],
  "api_available": "unknown",
  "system_requirements": "",
  "compliance": [
    "HIPAA",
    "HITECH",
    "SOC 2",
    "ISO 27001"
  ],
  "certifications": [
    "FDA 510(k)",
    "CE/MDR",
    "ONC",
    "ISO 27001"
  ],
  "security_features": [
    "Encryption",
    "RBAC",
    "SSO/SAML",
    "audit logs",
    "2FA"
  ],
  "privacy_features": [
    "BAA available",
    "consent mgmt",
    "anonymization",
    "data minimization"
  ],
  "data_residency": "US/EU regions",
  "customers": [
    "Houston Methodist",
    "St. Luke's Health System",
    "Alpine Physician Partners",
    "Eventus WholeHealth",
    "Cleveland Clinic",
    "Onvida Health",
    "John Muir Health",
    "Ardent Health-affiliate Utica Park Clinic"
  ],
  "user_reviews": [
    "I no longer exist in the perpetual dread of keeping up with documentation, and I have more mental clarity and presence with others at work and home."
  ],
  "ratings": [
    "97.7% customer satisfaction (KLAS Research)"
  ],
  "support_channels": [
    "email",
    "phone",
    "chat",
    "ticketing"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online"
  ],
  "release_year": "2020",
  "integration_partners": [
    "Epic",
    "athenahealth",
    "Cerner",
    "AdvancedMD",
    "eClinicalWorks",
    "Elation",
    "Microsoft Azure",
    "Microsoft AppSource"
  ],
  "id": "SW2648",
  "slug": "hcc-compliance-validator",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/hcc-compliance-validator.json"
  }
}