- HCC Retrospective Coding
Strengthen Your Medicare Advantage Success with Spotless HCC Accuracy
Premeditate MA clinical Functions by Leveraging accurate Retrospective Coding.
Our HCC Coding helps boost accuracy and optimize reimbursement
Offers Personalized Care Strategies
Precise coding enhances grasp of patient health history, aiding personalized care strategies, promoting patient-focused delivery.
Strengthens Financial Stability
Accurate HCC coding ensures financial stability, reflecting patient health status, improving resource allocation, and enabling investment in care.
Impacts Care Delivery
Improved HCC coding directly influences care delivery, fostering tailored and personalized care plans that enhance health outcomes for patients.
Ensures Fairness in Reimbursement Models
Accurate coding fosters fair reimbursement, enhancing provider stability and enabling growth while prioritizing superior patient care.
Understanding Health Plan Needs
Harnessing the power of AI provides health plans with Strategic What-Ifs and Practical How-Tos
Our AI-driven cNLP clinical workflow pinpoints clinical inaccuracies in HCC coding, mitigating the risk of significant revenue losses and reducing the likelihood of regulatory scrutiny and penalties.
Missed HCC Opportunities
Potential diagnosis codes not captured in the documentation and which could impact risk adjustment and reimbursement
Compliance Risks
Inaccurate HCC coding, documentation deficiencies, and non-adherence to Medicare Advantage program regulations result in audit scrutiny and penalties.
Operational Burden
In the pre-audit phase, clinical teams face heavy workloads and stress in meeting deadlines, which contributes to worsening inefficiencies, causing team burnout.
Missed HCC Opportunities
Potential diagnosis codes not captured in the documentation and which could impact risk adjustment and reimbursement
Compliance Risks
Inaccurate HCC coding, documentation deficiencies, and non-adherence to Medicare Advantage program regulations result in audit scrutiny and penalties.
Operational Burden
In the pre-audit phase, clinical teams face heavy workloads and stress in meeting deadlines, which contributes to worsening inefficiencies, causing team burnout.
The RAAPID Advantage
Why Partner With RAAPID for HCC Retrospective Coding?
Utilize top-tier AI solution to enhance care quality, adhere to compliance standards, and attain your revenue objectives effectively.
Maximize Revenue
"Increase RAF scores with accurate code capture."
Mitigate Risk
"Reduce compliance risks and protect your bottom line."
Streamline Operations
"Free your team with AI-assisted review."
Technology That Drives Accuracy
Advanced Technology for Precision HCC Coding
State-of-the-art AI-powered chart extraction guarantees accurate and actionable diagnoses by analyzing unstructured data and reduces the risk of errors. Experience the rapid validation of medical records through Neuro-Symbolic AI, which accelerates decision-making and cuts costs.
Our Neuro-Symbolic AI-driven Clinical solution offers the following benefits:
Automates and prioritizes workflow queues to eradicate backlogs and enhances overall performance effectively.
Our Neuro-Symbolic AI Clinical solution enables coders to review and validate medical records swiftly, speeding up decision-making and effectively reducing expenses.
A thorough audit trail to ensure easy distribution of all ICD & HCC codes and reviewer actions, minimizing compliance risks.
Why RAAPID
MA Retrospective Risk Adjustment Management: Cracking the code
The effectiveness of our NLP Platform is evidenced by its ability to identify 55% more diagnoses compared to relying solely on ICD10-CM codes.
Explore our services
The Right HCC Coding Support for Your Needs
Alleviate complexities linked to overseeing numerous vendors and bolster the effectiveness of your risk adjustment initiatives.
HCC Retrospective coding identifies missed or incorrect HCC codes, requiring a secondary review and correction process before resubmitting claims to payers, as is the case with Medicare Advantage plans.
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Optimized RAF scorePerfect your RAF scores and improve ROI by 10X -
Uncover missed HCCsUncover suspect diseases and code with increased speed and accuracy.
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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.
Using Clinical NLP, our Retrospective Risk Adjustment solution auto-captures HCC codes based on MEAT criteria, resulting in accurate coding and reimbursement.
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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.
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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.
Ensures compliant-proof accurate submissions by rectifying coding errors before submission happens. Our NLP engine offers comprehensive Compliant-standard support for HCC validations along the depth and breadth of charts.
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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.
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Be audit-readyGiven the new RADV audit regulations and the forthcoming V28 migration RAAPID is fully dedicated to prepare your organization to be audit ready. -
Team Synergetic SolutionIn collaboration with customers and partners, we’re committed to addressing industry challenges in the risk adjustment sector.
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