The Score Is Not Enough: Building Reviewable Risk-Adjustment Software
Risk-adjustment software earns trust when it preserves enough of the scoring path for another person, or another tool, to inspect it. A Risk Score Is The End Of A Longer Path A risk-adjustment run rarely ends with the person who wrote the scoring command. An analytics team receives a subject file and a diagnosis file for a new reporting cycle. The data may come from claims, eligibility records, internal extracts, or a prepared research dataset. Someone runs the scoring workflow and produces a table of subject-level risk scores. The file is useful. It may feed a quality model, a review queue, a payment analysis, a monitoring dashboard, or an internal validation package. ...