Why Risk Adjustment Matters More Than Ever: Sunil’s Journey From Medicine to Health Tech

Welcome to the very first episode of Care Decoded , where we peel back the layers of healthcare innovation with people who are reshaping the industry from the inside. In this episode, Dr. Sunil Nihalani, Founder and CEO at Inferscience, dives into his unconventional journey from his childhood in India where his family was far from medicine to the creation of Inferscience, a company dedicated to making risk adjustment and clinical documentation more efficient for physicians and payers. Sunil tackles some of the most pressing challenges in healthcare today, like navigating clunky electronic medical records (EMRs), the true pain points behind documentation, and how artificial intelligence is poised to actually help rather than just add to the hype. Sunil shares personal stories from his career, what inspired him to move from bedside care to tech entrepreneurship, and why he believes thoughtful technology can actually give doctors back the time and passion for patient care. If you’re a physician bogged down by endless paperwork, a healthcare leader or a payer looking for real examples of AI making a difference, or just curious about how risk adjustment is impacting patient care and funding, this episode will inspire and maybe even challenge your views. Let’s get decoding! Timestamps: 00:00 Improving Patient Care with EMRs 06:09 Unexpected Breakthrough in Risk Adjustment 09:37 Importance of Accurate Medical Documentation 11:21 AI Scribes Improve Clinical Efficiency 16:21 Physician Data Review Challenges 18:27 Physician-Led Healthcare AI Innovation 22:18 Medical Imaging & Prior Authorization Rules 25:10 Global Tool for Physician Data Summarization 26:58 Balancing Gratification and Business Challenges Podcast's Website - https://caredecoded.com/ Dr. Sunil Nihalani - CEO and Founder at Inferscience - https://www.linkedin.com/in/sunil-nihalani-a6983a5/ Inferscience - https://www.inferscience.com/ Podcast Powered by TopHealth - https://tophealth.care/ “Disclaimer: Informational only. Not medical advice. Consult your doctor for guidance.”