Encipher Health

Encipher Health provides an AI-driven platform that automates and streamlines medical coding and billing for healthcare providers and payers. Founded in 2023 by Prem Kumar P, who also serves as CEO, the company is headquartered in Chennai, India, with a U.S. office in Wilmington, Delaware. The firm was incorporated on November 7, 2023.

The company's core business revolves around its multi-specialty AI platform, which utilizes optical character recognition (OCR), machine learning (ML), and natural language processing (NLP) to convert raw patient data into actionable insights for medical coding. This technology is designed to improve coding accuracy for Hierarchical Condition Categories (HCC), ensure accurate Risk Adjustment Factor (RAF) scores, and optimize billing, thereby increasing operational efficiency and reducing costs for healthcare organizations. The platform's neuro-symbolic generative AI integrates reasoning and self-correction to enhance reliability, reportedly achieving over 95% accuracy in risk adjustment coding and processing reviews at a rate ten times faster than traditional methods. Its product suite includes 'Cogent AI' for HCC risk adjustment, 'Sedate AI' for anesthesia-focused data extraction, and 'Conrad AI' for radiology coding.

Encipher Health operates on a B2B model, serving healthcare providers, payers, and medical coders. In June 2025, the company announced a strategic partnership and investment from 3Gen Consulting Services to advance its AI-driven risk adjustment solutions in the U.S. healthcare market. The firm is also a partner in the NVIDIA Inception program, utilizing advanced GPU and AI technologies to enhance its data processing capabilities.

Keywords: medical coding automation, risk adjustment solutions, healthcare AI, revenue cycle management, HCC coding, clinical documentation improvement, natural language processing, value-based care, medical billing AI, healthcare data analytics, predictive analytics, workflow automation, RAF score optimization, AI-driven diagnostics, automated chart validation, payment integrity, digital health, health-tech, medical data management