Let’s Explore!
HCC Documentation and Coding are central to Risk Adjustment Goals
HCC documentation provides a comprehensive depiction of the intricate details of medical treatment and offers an overall understanding of the health condition of the patient. HCC coding in combination with precise recording of diagnosis (DX) codes, becomes instrumental in determining cost metrics and risk-adjusted qualities. It is specifically scoped for population health management and, therefore, takes into account factors like demographic complexity, cost, and quality of medical treatment. This systematic approach ensures accurate reimbursement, effective care delivery, quality improvement & Audit-readiness, targeted population health interventions, and significant contributions to medical research and public health initiatives by healthcare organizations.
Solutions Overview
Empower Your Risk Adjustment Strategy with Our Transformative Solutions
Explore our customizable end-to-end risk adjustment solutions tailored to your healthcare organization. Choose from:
Retrospective Risk Adjustment
Our Clinical NLP Solution uses proprietary algorithms to optimize risk scores by capturing unreported HCC conditions/codes. It also uncovers wrongly submitted codes as they did not meet documentation guidelines.
Prospective Risk Adjustment
Prospective Review utilizes RAAPID’s CNLP integrated with LKMs( Large Knowledge models ) to expedite gap closure with unmatched accuracy.
Our AI-based solution detects missing diagnosis codes from previous encounters and generates suspected error lists.
CMS Audit Risk Adjustment Solution
RAAPID’s MEAT-enabled CMS-HCC RADV risk adjustment solution efficiently manages auto code suggestions, facilitating compliant Coding and quicker VBC claim data audit with better ROI in just 3 clicks.
Retrospective Risk Adjustment
Our Clinical NLP Solution uses proprietary algorithms to optimize risk scores by capturing unreported HCC conditions/codes. It also uncovers wrongly submitted codes as they did not meet documentation guidelines.
Prospective Risk Adjustment
Prospective Review utilizes RAAPID’s CNLP integrated with LKMs( Large Knowledge models ) to expedite gap closure with unmatched accuracy.
Our AI-based solution detects missing diagnosis codes from previous encounters and generates suspected error lists.
CMS Audit Risk Adjustment Solution
RAAPID’s MEAT-enabled CMS-HCC RADV risk adjustment solution efficiently manages auto code suggestions, facilitating compliant Coding and quicker VBC claim data audit with better ROI in just 3 clicks.
Services Overview
Maximize Results through Our Specialized Risk Adjustment and HCC Coding Services
Leverage our suite of specialized Chart review & Audit services with the utmost comprehensive member data at your disposal for maximum benefit:
RAAPID’s Technologies conducts detailed chart reviews, analyzing past service dates to extract precise HCC conditions (unreported/unsubstantiated HCC codes) and identifying gaps for improved risk-adjustment payments.
-
Optimized RAF scorePerfect your RAF scores and improve ROI by 10X -
Uncover missed HCCsUncover suspect diseases and code with increased speed and accuracy.
-
Reduced recoupmentsEnsure reimbursement based on severity and complexity of the patient’s condition. -
Streamline chart reviewOur cNLP makes accurate chart abstractions and identifies each patient’s disease condition.
HCC codes are accurately verified & documented in patient records to comply with CMS/HCC requirements, enabling physicians to address identified opportunities via EHR updates or pre-appointment briefings.
-
Point-of-care codingImprove compliance & eliminate coding obstacles through evidence-based coding done at the point of care. -
Compliant workflowsUsing the cNLP RA solution, we offer clinicians real-time documentation feedback to ensure compliance.
-
Low claim denialsOur point-of-care coding practice & evidence-based documentation minimize claim denials and rework. -
Proactive CareRAAPID’S Previsit Solution analyzes 360-degree longitudinal patient data, addresses care gaps, and enhances patient outcomes.
Using Clinical NLP, our Retrospective Risk Adjustment solution auto-captures HCC codes based on MEAT criteria, resulting in accurate coding and reimbursement.
-
Recover revenueOur built-in suspect analytics recaptures code for missing chronic conditions, minimizing reduced reimbursement. -
Improve qualityWe ensure accurate assignment of HCC values, resulting in better care outcomes.
-
Gain actionable insightsOur clinical NLP, combined with a knowledge graph, automates code-suggested chart review and provides actionable clinical insights. -
Optimize resourcesOur technology automates intricate manual tasks, extracting data and assigning codes, ensuring efficiency.
Our MEAT-enabled Retrospective Risk Adjustment solution streamlines chart audits by detecting under or over-coding, ensuring adherence to regulatory compliance.
-
Compliant codingOur technology guarantees compliance by providing automatic code suggestions and real-time support. -
Risk mitigationBy conducting 1st & 2nd level reviews to validate codes, we assist in preventing penalties and legal issues.
-
Be audit-readyGiven the new RADV audit regulations and the forthcoming V28 migration RAAPID is fully dedicated to preparing your organization for potential audits. -
Accurate codingIn collaboration with customers and partners, we’re committed to addressing industry challenges in the risk adjustment sector.
RAAPID’s AI-powered technology conducts detailed chart reviews, analyzing past service dates to extract precise HCC conditions (unreported/unsubstantiated HCC codes) and identify gaps for improved risk-adjustment payments.
-
Better ROIRAAPID’s Risk Stratification process prioritizes charts of high-risk patients, potentially enhancing ROI. -
Time-savingOur Analytics guides coders to relevant medical charts, accommodating preferences and emphasizing suspected conditions.
-
Data-driven decisionsWith our AI-driven ICD coding tool, we empower coders to streamline workflows and optimize resource allocation. -
Better trainingWe offer training on high-risk diagnosis codes that have been red-flagged.
Technology Spotlight
Explore the power of AI-driven Integrated Compliance for Enhanced ROI
RAAPID’s Core Solutions help you to deliver Compliant proof submissions and minimize inaccurate member/patient profiles, resulting in optimized reimbursements
Clinical NLP
RAAPID solution engineering offers end-to-end risk adjustment services, Integrating clinical data into a unified workflow enriched with NLP insights.
OCR in Healthcare
Our in-house OCR technology, paired with RAAPID’s CNLP engine, enables multi-format risk recapture, closing coding gaps and optimizing risk assessment scores.
Healthcare APIs
Our cloud-agnostic SaaS platform, integrated with RAAPID’s core capabilities via APIs, ensures improved accuracy and compliance, enhancing revenue capture.
Neuro-Symbolic AI
Experience the combined strengths of symbolic AI Knowledge Graphs and neural networks enabling human-like clinical decision-making process
The RAAPID Advantage
Why Choose RAAPID for Risk Adjustment?
Experience the benefits of working with RAAPID
Increase accuracy and completeness in HCC coding
Our AI-based core engineering solution built on a robust Clinical rules engine enables increased accuracy and completeness in HCC coding, leading to optimized RAF scores
-
Precision SolutionOur (HCC) coding best practices involve a dual approach of accuracy and meticulousness -
Optimized ScoreAI-based Clinical rule affirms your RAF scores hit the mark every time!
Automate tedious processes and streamline workflows
Our cutting-edge Knowledge Graph-based (NLP) technology interprets charts like a human coder, automatically providing precise risk adjustment codes and minimizing manual intervention.
-
Knowledge Graph-based (NLP) technologyNLP’s technology-driven Knowledge Graph decodes charts the way humans do. -
Auto-code generationReliable code suggester that makes accurate risk adjustments every time, spot on!
Drive better decision-making at the point of care
RAAPID offers tailored analytics that tracks real-time performance indicators, which helps transform data into actionable insights. Built-in codebooks aid in timely, accurate, data-driven decision-making for clinical teams.
-
Real-time processingCustomized analytics acts as a data wizard, transforming real-time metrics into actionable insights in seconds! -
Built-in codebooksTrusted companions for clinical teams, aiding swift, accurate data-based decisions.
Transparent, ethical AI with clear interpretations
RAAPID’s Explainable AI technology is based on clinically trained NLP and knowledge graph approach, crafting purpose-built Large Knowledge Models for various Risk Adjustment scenarios.
-
Explainable AI technologyAt the core is RAAPID’s AI, which blends brilliantly with our cNLP and knowledge graphs. -
Risk Adjustment scenariosRAAPID’s Explainable AI technology constitutes smart Large Knowledge Models tailored to meet complex Risk Adjustment scenarios.
RAAPID unlocks Data Insights Efficiencies Decision Making
RAAPID unlocks
Data Insights Efficiencies Decision Making
Trapped within Unstructured Data
RAAPID unveils the efficiency of data insights for informed decision-making, breaking through the constraints of unstructured data. We are revolutionizing Value-Based Care and Risk Adjustment with our tried and trusted AI technology platform, honed over a decade.
Ensuring a comprehensive approach to each patient’s data, Capturing the entirety of the clinical picture to enhance RAF scores. Our AI enhances human interventions by automating manual processes, allowing them to concentrate on crucial matters:
- HCC Code Validations
- Suspect Analytics
Risk Adjustment Solution
Modern AI-Powered Risk Adjustment Solution Provider
RAAPID’s NLP Platform is an AI-based technology that process the ingested raw patient data “ – both unstructured and structured format – ” from multiple sources and transforms them into a usable form. Our NLP platform helps to identify risk, improve quality of care, close gaps, and focus on financial performance.
Statistics & Impacts
Modern AI-Powered Risk
Adjustment Solution Provider
>
0
Years of Healthcare
& AI Experience
>
0
%
Healthcare Clients Served
>
0
X
Return On Investment
>
0
%
Increased Efficiency
& Productivity
>
0
%
Complete, Defensible Risk Scores
>
0
X
Reimbursement
Accuracy
We maintain a "ZERO tolerance & ZERO Compromise" policy towards data/Cyber Security
Trending Topics revealing Industry Insights
A peep into the world of Healthcare Risk Adjustment
Insights to help you do what you do better, faster and more profitably.
We Are Always Ready To Support & Clarify All Your Queries
Let's Partner & Embark On A Promising & Collaborative Journey
Leave all your technological concerns behind – we will take care of it. Let’s move forward from Risk to Revenue