On-the-Glass HCC Coding: Capturing Risk at the Point of Care

For two decades, risk adjustment has been a rear-view-mirror exercise: pull charts after the visit, hunt for missed conditions, and try to re-document them before the submission deadline. It works, but it is expensive, it is late, and it depends on a provider remembering a patient they saw months ago.

The shift happening now is toward point-of-care — surfacing the opportunity while the encounter is open, on the same screen the provider is already using. We call it on-the-glass, and it changes the economics of risk adjustment.

Why the point of care is the highest-yield moment

When a suspected HCC surfaces during the visit, three good things happen at once:

• The provider has full context. They are looking at the patient, not reconstructing a months-old encounter from a query.
• The documentation is created correctly the first time. A condition addressed in the live note satisfies MEAT naturally — no retrospective query, no addendum, no compliance gray area.
• Nothing leaks. Conditions that would have been forgotten by the time a coder reviewed the chart are captured at their freshest.

Retrospective review will always have a role. But the conditions you catch in the room are cleaner, cheaper, and more defensible than the ones you chase later.

The friction problem — and how to remove it

The reason point-of-care coding historically failed is friction. Providers will not log into a second system, learn a new tool, or break their charting rhythm. Any solution that adds clicks loses.

So the design constraints are strict. An on-the-glass layer has to:

• Live inside the EHR the provider already uses — docked beside the chart, not in a separate tab.
• Require zero extra logins — credentials pass through from the EHR session.
• Stay quiet until wanted — a count of opportunities on the screen edge, never a pop-up storm.
• Explain itself — every suggestion ranked and backed by a rationale and the exact source passage, so the provider trusts it in seconds.

That last point matters most. A suggestion the provider cannot immediately verify is a suggestion they will dismiss. When the evidence is one click away — highlighted in the source document — acceptance becomes a reflex, and the code is written straight back into the note.

It is one surface of a connected platform

On-the-glass is where providers act, but it is not the whole story. The same engine feeds a full coder and administrator workspace: documents arrive like email, coders review evidence-first, and administrators track exactly what was presented, accepted, and — tellingly — what providers never touched. The sidecar and the back office run on one engine, so a code captured in the room is the same code your analytics and audit trail already understand.

The result

Point-of-care capture turns risk adjustment from a quarterly recovery project into a continuous, low-friction habit. Providers do their normal work; the platform makes sure nothing supported by the record goes uncoded; and your coders spend their time on validation and complex cases instead of hunting for the obvious.

*Curious what on-the-glass coding looks like inside your EHR? Schedule a live demo and we'll walk you through it on a real chart._