Boosting Outpatient CDI Accuracy While Reducing Provider Burnout
Clinical Documentation Improvement (CDI) plays a critical role in ensuring accurate patient records, appropriate reimbursement, and …
Enhancing Care Delivery with Risk Adjustment for ACOs: A 2025 AI-Driven Strategy for Chief Medical Officers
Introduction ACO Key Challenges Faced by CMOs Submission Timeline Planning RAAPID Risk Adjustment Solutions: Helping ACOs …
Proactive PCPs: Future Lies in Prospective Risk Adjustment Solutions
As healthcare moves toward value-based models, primary care providers (PCPs) and health plans face increasing pressure …
CMS Risk Adjustment Submission Deadlines for 2025, 2026, and 2027: Key Dates for Compliance
In the intricate world of value-based care, where precision and accuracy can make all the difference, …
Rethinking Risk Adjustment: Treading Carefully into the Next Chapter of Risk Adjustment (Part II)
As CMS finalizes the 2026 payment policy updates for Medicare Advantage and Part D programs, the …
Rethinking Risk Adjustment: The Move to MA Encounter Data and What It Means (Part I)
The Centers for Medicare & Medicaid Services (CMS) has laid the groundwork for a transformative shift …
RADV Audits in 2025: What MAOs Must Know About the 2023 Final Rule and the PY2018 Audit Risks
Introduction Understanding the 2023 CMS Final RADV Rule CMS’s First RADV Audit Notices for PY2018 The …
CMS-HCC Model V28: What Health Plans and Providers Must Do to Stay Ahead
As the healthcare landscape evolves, the transition to the CMS-HCC (Hierarchical Condition Category) Model V28 represents …
Top Risk Adjustment Coding Companies for Accuracy and Efficiency in 2025
Understanding Modern Risk Adjustment Needs What is Risk Adjustment? Leading Risk Adjustment Technology Companies Technology Innovation …
Top 7 AI Risk Adjustment Softwares that are Winning Customer Trust in 2025
Risk adjustment software is no longer just an optional tool; it is a necessity for healthcare …
Understanding Risk Adjustment Coding in Healthcare: A Complete Guide for 2025
The healthcare industry continues to evolve, with risk adjustment coding playing an increasingly central role in …
Concurrent Coding in 2025: How AI-Powered Solutions Transform Real-Time Risk Adjustment
Concurrent vs Retrospective Coding: Real-Time Advantage in Risk Capture Real-Time Risk Adjustment: Measured Impact on Documentation …
Selecting the Right Risk Adjustment Vendor: Essential Checklist for 2025
Risk adjustment services have transformed from simple coding solutions into comprehensive programs impacting every healthcare delivery …
From the Desk of the CHRO @RAAPID INC
A Shared Vision for People Excellence At RAAPID Inc., our greatest strength lies in our people. …
Why Medical Directors are turning to AI for Annual Wellness Visits Management
Introduction Importance of ‘Annual Wellness Visits’ for Providers Hidden Challenges in Traditional Annual Wellness Visits Annual …
Maximizing Revenue and Reducing Audit Risk: How Retrospective Risk Adjustment Can Help ACA Plans Meet 2025 Deadlines
Background Maneuvering Through the Nuances of ACA Risk Adjustment ACA Deadlines 2025 And How They Affect …
How Providers and Technology Can Collaborate for Quality Care in 2025
Introduction The Importance of Year-End Preparation Why a Comprehensive Year-End Audit Holds Key Relevance Adopting AI-driven …
Gaining a Holistic Patient Health Perspective With RAAPID’s AI for Optimized Care
Introduction AI-Empowered Foresight For Comprehensive Patient Health Understanding NLP Emerges As The Pivotal Remedy AI-Powered Prospective …
Advanced AI Technology Sharpens Provider Precision in Healthcare Data Management
The transition to ICD-10 has been a monumental leap in healthcare, expanding from 14,000 to over …
Debunking the Myths Around AI in Medical Coding
Coder Dilemma: A Techno-Philosophical Reflection Myth #1: NLP Replaces the Need for Human Coders, Leading to …
Bridging the Risk Adjustment Continuum for Collaborative Payer-Provider Success
Risk Adjustment Continuum Is Premised On Payer-Provider Collaboration Understanding The Risk Adjustment Continuum In Changing Times …
How Forward-Thinking Health Plans Are Achieving Better Value by Leaving the Past Behind
Evolution of Forward-Thinking Health Plans The evolution of forward-thinking health plans serves as a profound reminder …
RAAPID at RISE West 2024: Showcasing AI-powered Prospective Risk Adjustment Solution & ChaiseIQ to Create Chase List
RISE West 2024: Expanding the Horizons of Healthcare & Risk Adjustment We are thrilled to participate …
Improve Compliance and Financial Performance with a PCP-Centric Risk Adjustment Program
The arrival of new regulations such as the RADV Final Rule and the 2023 Final Rate …
How to Resolve HCC Gaps: Best Practices for Healthcare Providers
Table of Content: HCC Primer Workability of HCCs Importance of HCC Coding underlying the risk adjustment …
Achieving Compliance and Accuracy: The Power of Retrospective Risk Adjustment
As value-based care providers and organizations aim to ensure accurate risk adjustment for Medicare reimbursement, understanding …
Industry Trends to Stay Ahead in Risk Adjustment Coding and Quality Care
Ever wonder how healthcare plans balance their premiums despite enrolling individuals with varying health risks? Enter …
Ethical Dimensions of AI in Shaping the Future of Risk Adjustment
Balancing financial sustainability and high-quality patient care in value based healthcare is challenging, especially with disparities …
Best Practices for Health Plans to Run a Profitable & Compliant Risk Adjustment Program
Healthcare Plans are in constant flux, making it vital for Medicare Advantage Organizations (MAOs) and medical …
2025 Medicare Advantage Final Rule is out – All You Need to Know
Are you ready for major changes impacting your healthcare costs in 2025? Even though it’s several …
Trends in Medicare Advantage 2024 and Beyond: Here’s What Industry Experts Are Talking About
In the ever-evolving Medicare Advantage risk adjustment landscape, understanding the shifts and developments is crucial for …
How to increase Medicare Advantage Star Ratings by running an effective RA program
How CMS Star Ratings are assessed The Centers for Medicare & Medicaid Services releases its quality …
In Pursuit Of Accuracy: Impact Of AI On MA Medical Record Audit Solutions
Retrospective Audit and its importance for MA organization Ensure quality care is being provided to Medicare …
From Booth to Boardroom – RAAPID Wrap on RISE National 2024
In humble appreciation, we acknowledge that attending conferences transcends mere networking and product showcases. It’s a …
Augmenting Near-Human Reasoning with “Neuro-Symbolic” AI for Profitable and Compliant Risk Adjustment Programs
Introduction Why Neuro-Symbolic AI Neuro-symbolic AI strives to blend the strengths of both domains Neuro Symbolic …
Enhancing Risk Adjustment Success: RISE National 2024 & RAAPID’s Innovative Solutions
Rising To The Occasion Amidst a Collaborative Spirit RAAPID’s Cutting-Edge Solutions Unveiled At RISE National 2024 …
CMS Unveils Proposed Changes for 2025 in Medicare Advantage and Part D Advance Notice
Between 2024 and 2025, payments to Medicare Advantage plans are anticipated to increase by an average …
Deciphering HCC Risk Adjustment Models in A Nutshell
Introduction The Hierarchical Condition Category (HCC) risk adjustment model, initially introduced by CMS in 2004, serves …
2024 Sweeping Changes to Medicare Advantage Risk Adjustment for Health Plans
CMS UNVEILS THE PROPOSED FINAL RULE FOR MEDICARE ADVANTAGE IMPACTING HEALTH PLANS, PROVIDERS & PATIENTS. The …
HCC Score: Enhancing Chronic Disease Management in Healthcare
Healthcare providers today face the challenge of effectively managing chronic diseases, a task made more complex …
Adapting to Change: Health Plans and the 2024 Medicare Advantage Star Ratings
The release of the 2024 Medicare Advantage Star Ratings marks a critical juncture for health plans …
CMS Proposes Major Changes to Medicare Advantage HCC Codes in 2024
Table of Content: Understanding the Revisions in HCC Codes The Impact on RAF Scores RAAPID’s Approach …
CMS Proposed Rule for 2025 MA, Prescription Drug Plans
The Centers for Medicare & Medicaid Services (CMS) recently unveiled a comprehensive CMS proposed rule for …
The Role of HCC RAF in Patient Care
Introduction In value-based care, Hierarchical Condition Category (HCC) and Risk Adjustment Factor (RAF) scores are more …
Navigating the Complexities of Medicare Risk Adjustment for Health Plans
The Medicare Risk Adjustment landscape is a complex one, with health plans constantly striving to ensure …
How Accountable Care Organizations (ACOs) Can Implement prospective Risk Adjustment using AI
Introduction Implementing a prospective risk adjustment solution in ACOs presents multifaceted challenges. Daily, there’s the arduous …
How Health Plans Can Reduce Audit Risk with NLP-powered Retrospective Solution
In the complex healthcare landscape, where regulatory oversight is rigorous and financial risks loom large, health …
The Power of Data Interoperability: What it Means for Prospective Risk Adjustment
Data interoperability has emerged as a pivotal force in healthcare, especially in the context of prospective …
Leverage RAAPID as Your Trusted HCC Coding Service Provider for VBC
In the ever-evolving landscape of healthcare, health Plans are constantly seeking efficient and reliable solutions to …
Addressing Provider Burnout: How Prospective Risk Adjustment Solutions Can Make a Difference
Healthcare providers, including physicians, nurses, and administrative staff, are the backbone of the healthcare industry. Their …
A Glimpse into the President and VP of Sales’ Remarkable Experience at the RISE West 2023
Nestled in the southwest, just a stone’s throw from Dallas Fort Worth international airport, the Omni …
Unlocking Precision: The Journey to Excellence with RAAPID’s HCC Coding Analysis Tools
Embarking on a Quest for Precision In the sprawling realm of healthcare coding, precision isn’t just …
Easing Physician Burnout: How NLP is Transforming Clinical Coding Administrative Burdens
Physicians are the unsung heroes of healthcare, dedicating their lives to saving others. However, the relentless …
The Many Benefits of
AI-Based ICD-10 Coding for Medical Coders
The field of medical coding plays a crucial role in healthcare, ensuring accurate and standardized documentation …
Tips to Code Faster & Accurate for CMS/HCC
Are you tired of spending countless hours in order to ensure efficient coding for Centers for …
RAAPID Pre-Encounter CDI Prospective NLP Analytics for HCC Capture Optimization
The business of healthcare delivery requires a combination of learned, attentive patient care and thorough documentation …
How Automation Can Transform the Way Health Plans Conduct Their Medical Chart Auditing
As the healthcare industry continues to evolve and become more complex, health plans are constantly seeking …
Revolutionize Healthcare Documentation: How Natural Language Processing Can Improve Diagnosis Coding Accuracy
As healthcare professionals, we know that accurate documentation is essential for quality patient care, billing, and …
Avoiding Common Pitfalls in HCC Risk Adjustment Coding Reviews: Tips and Tricks for Health Plans
Are you tired of sifting through mountains of coding reviews, only to find the same mistakes …
Enhance Your HCC Code Review & Audit with Easy-to-Integrate Solutions
As a healthcare professional, you understand the importance of accurate coding and documentation, especially when it …
Ensuring Fair Compensation: The Role of HCC Coding in Healthcare Billing
Welcome to our latest blog post about a crucial element of healthcare billing: Hierarchical Condition Category …
Best Practices for Successful Risk Adjustment Documentation and Coding in Value-based Care
If you’re still struggling to get a handle on risk adjustment documentation and coding, don’t worry-you’re …
How Risk Adjustment NLP Benefits Healthcare Payers
To remain solvent and profitable, healthcare payers must constantly seek new ways to optimize their operations, …
From Confusion to Clarity: Simplify HCC Coding with
MEAT-Enabled Solution
Are you tired of the complexity and confusion that comes with hierarchical condition category (HCC) coding? …
RAAPID’s NLP technology for Retrospective HCC Code review
With many healthcare organizations transitioning to value-based care (VBC) programs, ensuring accurate hierarchical condition category (HCC) …
Checklist for MA organizations to ensure accurate reimbursements
With the recent Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) Final rule update shared by …
How to choose the right HCC Coding Service Provider
In the release of the Medicare Advantage Risk Adjustment Data Validation Final Rule by the US …
Benefits of Outsourcing HCC Medical Coding Services to a Technology Solution Provider
Are you preparing for the upcoming 2023 Mid-Year risk adjustment data submission? Are you worried about …
Impact of Accurate HCC Coding for CMS Reimbursements
Hierarchical condition category (HCC) coding is a risk-adjustment model which is designed to estimate future healthcare …
Importance of Risk Adjustment in
Value-Based Care
Risk Adjustment is a statistical process that considers the underlying health status and health spending of …
Red Flags: OIG Chart Reviews of Medicare Advantage records
Healthcare fraud and misuse is a federal offense and negatively impacts care delivery on the whole. …
The role of Medical Coders in the Revenue Cycle Management
Medical coders play an important role in the revenue cycle management for the healthcare ecosystem, however, …
Retrospective Audit: How RAAPID is helping Health Plans & Providers
An AI-Based Risk Adjustment Coding solution does more than simply identify bad claims to fix them, …
Data-driven Analysis and Solutions with RAAPID
There are 3,834 Medicare Advantage Programs¹ as of 2022, and the total Medicare Advantage enrollees have …
Conventional vs. AI-Driven health care risk adjustment solutions
The global natural language processing (NLP) market revenue is expected to reach 43 billion in 2025.¹ …
4 Medical Coding practices for health care coders and payers in Risk adjustment
Hierarchical Condition Categories (HCCs) and ICD-10-CM codes risk adjustment solution is becoming a trending topic amongst …
Retrospective Solution for Audit: The role of Payers in Healthcare
With the modern technology inclusion in the health care ecosystem, payers will have to be coerced …
Payers in Health care: Chart Review Trends to watch in 2022
A survey conducted to understand the healthcare payer market size, shares, trends, and analysis stated that …
Retrospective Chart Audit Approach & Its Solution
One of the most common barriers to conducting patient chart reviews for the health care payer …
NLP & AI: Insurance Industry Future Trends for Risk Adjustment
A Study by the National Library of Medicine¹ has stated that several types of Artificial Intelligence (AI) …
Clinical Chart Review: Traditional vs RAAPID
In a recent study by MarketsandMarkets conducted to understand the advantages of artificial intelligence (AI) in …
