Top 20 MA Plan Selects Invent Health for AI Risk Adjustment Coding

The plan is now live on Coder Workbench 2.0, chosen for AI-assisted coding that runs natively inside the electronic health record.

One of the nation’s top 20 Medicare Advantage plans has selected Invent Health for risk adjustment coding and is now live on Coder Workbench 2.0.

Invent Health won the engagement with a capability few vendors offer: AI-assisted coding that connects directly to the electronic health record, keeping coding, evidence, and the medical record in one place.

A plan of this size does not switch coding partners lightly. The decision points to where the market is moving. Large health plans want AI in the coding workflow, but they want a coder making the final call, not a black box. That is exactly how Coder Workbench 2.0 is built.

Most coding teams lose time moving between the electronic health record and a separate coding tool. They open a chart in one system, note what they find, and enter codes in another. Every switch slows the work and risks missing evidence. Coder Workbench 2.0 connects directly to the record, so the coding happens where the chart already lives.

Inside Coder Workbench 2.0, Invent Health’s NLP reads the clinical documentation and surfaces the evidence for each condition. The coder reviews what the AI found, confirms the code, and signs the chart. The AI surfaces what matters but never invents a diagnosis. This is coder-in-the-loop by design, and it is what large, audit-minded plans are asking for.

For a health plan, that means faster coding it can stand behind. A plan gets paid for the risk it can prove, and every code needs evidence a reviewer can see. Coder Workbench 2.0 keeps that evidence attached to the work from the first review through submission.

“A plan of this caliber does its homework before it selects a coding partner. What they saw is that we integrate directly with the EMR, bringing intelligence into the clinical record and workflow teams already use, while keeping a certified coder accountable for every decision. For twenty years, the industry connected systems and called it progress, but connection alone is not intelligence. This is what intelligent, clinically governed technology looks like in practice, and it is why plans of this size are moving our way.”

Rohit Bhardwaj Founder and CEO, Invent Health

What Coder Workbench 2.0 delivers

Coder Workbench 2.0 pairs certified coders with AI-assisted review. Health plans using the application see:

  • NLP evidence detection accuracy of 85 percent or higher out of the box
  • A 30 to 40 percent lift in coder throughput
  • Support for current CMS-HCC risk models, including V24 and V28
  • EMR integration enabling automated, secure chart retrieval
  • Integrated provider query workflows enabling timely clarification and seamless provider feedback during coding

The application uses a two-pass model, so human clinical judgment and technology-enabled validation both sit in the workflow. It runs in a HIPAA-aligned, SOC 2 Type II audited environment.

Coder Workbench is one part of Invent Health’s payer intelligence platform, which connects risk adjustment, quality, coding, and encounter submission so a plan can see the member, the evidence, the money, and the risk in one view.

About Invent Health

Invent Health is a Silicon Valley-based AI and analytics company that helps major health plans manage risk adjustment, coding, quality, and clinical data operations across Medicare Advantage, Medicaid, and ACA. Founded in 2019, the company supports more than five million members and has been recognized by AWS as an innovative healthcare company and honored with the TiE50 Global Innovation award. Learn more at inventhealth.com.

Media contact Kristin Knudson, Head of Marketing, Invent Health
kristin@inventhealth.com

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Questions, answered

Frequently asked questions


What is Coder Workbench 2.0?

Coder Workbench 2.0 is Invent Health's AI-assisted risk adjustment coding application. NLP reads clinical documentation and surfaces the evidence for each condition, and a certified coder reviews it, confirms the code, and signs the chart.

How does Coder Workbench connect to the medical record?

It integrates directly with the plan's electronic health record, so coders review the AI's findings and enter codes inside the record instead of switching to a separate tool. This saves time and reduces the chance of missed evidence.

Is Invent Health's AI coding fully automated?

No. It is coder-in-the-loop. The AI surfaces the evidence, but a certified coder makes every coding decision. The AI never invents a diagnosis.

How accurate is the AI-assisted coding?

Coder Workbench delivers 95 percent coding accuracy, with NLP evidence detection at 85 percent or higher out of the box.

Which risk models does Coder Workbench support?

It supports current CMS-HCC risk models, including V24 and V28.