AI & Technology

How Rekova Health AI pairs 30+ years of domain expertise with purpose-built AI tools to deliver faster, sharper, and more defensible risk adjustment analysis.

How We Use AI at Rekova Health AI

Rekova Health AI is built differently. Most of the industry treats AI as a bolt-on — a chatbot for drafting emails. We treat it as core infrastructure for the analytical work our clients actually pay for.

Every engagement draws on 30+ years of Medicare Advantage risk adjustment experience — including co-development of the Johns Hopkins ACG methodology — combined with a disciplined, AI-augmented workflow. That combination lets a small, senior team move at a scale and speed that would otherwise require a much larger staff.

AI-Augmented Analytics & Advisory

We use AI to accelerate — never replace — expert judgment:

Regulatory and audit analysis: Synthesizing CMS rules, OIG audit reports, and RADV methodology to identify exposure and defensible positions.
Risk adjustment modeling: Building and stress-testing simulations of clawback exposure, extrapolation methodology, and coding pattern risk.
Literature and evidence review: Rapidly surveying peer-reviewed and regulatory sources to support expert opinions and client deliverables.
Chart chase optimization: Applying data-driven methods to prioritize medical record retrieval for maximum coding accuracy at minimum cost.

Every AI-assisted analysis is reviewed and verified against primary sources before it reaches a client. AI drafts; we verify.

Custom Software, Built In-House

Beyond advisory work, we design and build purpose-built software — tools tailored to the specific, often overlooked problems in risk adjustment operations: audit tracking, chart chase prioritization, and coding pattern analysis. These tools come directly out of real consulting engagements, not generic off-the-shelf assumptions about what health plans need.

Data Security & Privacy

Rekova Health AI takes client data security seriously. Our AI-augmented workflows are designed with a clear principle: client data stays protected.

US-based and secure. Client data that is processed or stored resides exclusively on secure, US-based servers and is never transmitted to, shared with, or processed by external AI platforms or third-party models.
No external data sharing. Claims data, audit findings, chart review results, and any PHI are never submitted to or shared with outside AI platforms or third parties.
AI assists our experts, not our systems. Our AI tooling is used to augment the analytical judgment of our senior team. Raw client data is not an input to these processes.
Secure engagement protocols. All client deliverables and data exchanges follow encrypted, access-controlled workflows consistent with HIPAA requirements.
No model training. Client information is never used to train, fine-tune, or improve any AI model — internal or external.

Health plans, provider groups, and law firms trust us with sensitive data. That trust is foundational to everything we do.

Deep domain knowledge. Modern AI. No black boxes.

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