RiskWise Practice Solutions LLC
Why We Started RiskWise
We founded RiskWise after watching Primary Care clinics work tirelessly for their patients while quietly struggling under the weight of value‑based care. One small clinic in particular opened our eyes: dedicated providers, a loyal biller, and a leadership team doing everything right — yet still losing revenue, missing chronic conditions, and feeling overwhelmed by documentation and billing complexity.
They weren’t failing.
The system around them was.
What they needed wasn’t another vendor.
They needed a partner — someone who could bring clarity, structure, and support without replacing their team.
That moment shaped our mission.
11+
Years of Risk Adjustment Expertise
100%
HIPAA-Aligned Operations
98%
Supplemental Code Submission Accuracy
95-99%
Documentation Alignment with HCC Requirements
Why choose us?
Risk Adjustment Expertise
Multi-payor HCC knowledge tailored to primary care workflows.
Supplemental Code Submission
Accurate, compliant adds and deletes across payers to ensure complete diagnosis capture and stronger revenue integrity.
Provider-Centered Education
Clear, respectful coaching that improves documentation without adding burden
benefits
Your partner in Risk Adjustment & Revenue Integrity
RiskWise Practice Solutions LLC brings together two seasoned healthcare professionals, each with over a decade of experience supporting primary care providers in risk adjustment, documentation improvement, and revenue integrity. We combine deep multi‑payor expertise with practical, provider‑friendly workflows to help practices strengthen accuracy, compliance, and financial performance—so teams can stay focused on delivering exceptional patient care.
who we are
Driving Accuracy and Integrity in Value-Base Care
what we do
Risk Adjustment Support
We identify HCC opportunities, review charts, and strengthen documentation accuracy across payers
Supplemental Code Submission
We manage accurate, compliant adds and deletes to ensure complete diagnosis capture and stronger revenue integrity.
Billing Oversight
We strengthen billing accuracy by incorporating risk adjustment expertise into claim review, coding validation, and denial prevention workflows.
Workflow & Operational Design
We build clear, provider-friendly workflows, tools, and reporting that reduce administrative burden and improve consistency.
pricing
Clear, Predictable Pricing for Your Practice
Tier 1 - RA Essentials + Biller Oversight
$3000-$5000/month
INCLUDES:
- Monthly risk adjustment chart reviews
- Monthly supplemental diagnosis submissions
- Monthly biller QA (claims review, missed codes, feedback)
- Monthly provider documentation feedback
- Quarterly education refreshers
- Monthly RA performance reporting
- Email support for biller and providers
IDEAL FOR:
- Small to medium practices
- Practices missing HCC recapture
- Practices with inconsistent coding quality
Tier 2 - RA + Documentation Improvement Program
$5000-$8000/month
INCLUDES EVERYTHING IN TIER 1, PLUS:
- Comprehensive documentation audit (monthly or quarterly)
- Provider-specific education sessions
- Documentation templates and quick-reference guides
- Coding accuracy monitoring
- Annual recapture planning
- Monthly workflow optimization sessions
- Enhanced reporting (RAF trends, provider scorecards)
IDEAL FOR:
- Practices with multiple providers
- Groups with chronic documentation gaps
- Practices in value-based contracts
Tier 3 - Full RA + Documentation + Billing Workflow Optimization
$8000-$12000/month
INCLUDES EVERYTHING IN TIER 2, PLUS:
- Full billing workflow evaluation
- SOP creation and implementation
- Biller training program
- Monthly billing workflow audits
- Denial pattern analysis
- End-to-end RA + billing alignment
- Quarterly strategic performance reviews with leadership
IDEAL FOR:
- Larger practices
- Practices with chronic operational issues
- Groups transitioning to value-based care
