Build Risk Insights For Your Risk Adjustment Strategy with API-Driven RAF Score Batch Process.

Experience efficient RAF score bulk processing for large datasets. Easily upload files, check status, and securely download the risk data via a signed AWS S3 URL. Identify high-risk charts for prospective reviews. Find and Prioritize High-Risk Conditions and Care Gaps.

Efficiently Prioritize and Identify Charts with the Highest Risk Impact.

Provide data-driven solutions that enhance care quality, support compliance with CMS risk adjustment models, and improve reimbursement accuracy under Medicare Advantage and other value-based care contracts. It just not only provides RAF score but more importantly, it provides revenue opportunities for your financial forecasting and planning. NO PHI REQUIRED!

There are different use case scenarios in provider space that you can use this tool for:

Patient Risk Stratification for Prospective Review

Ensure accurate prioritization of high-value charts by avoiding selection based solely on Fee-For-Service value or random selection methods or by utilizing delta ICDs from current and past years. Process the entire volume of charts to filter out the top 20-30% of high-value charts for prospective reviews, enhancing efficiency and precision and saving costs in prospective reviews.

Eliminate the Need for Prospective HCC Coding Reviews

Prospective reviews are costly and often skipped by smaller providers due to uncertain ROI. RAF Score Batch Processing combined with concurrent review can potentially replace them, capturing up to 70% of revenue impact. Including recent labs and radiology in concurrent review helps identify remaining care gaps and address them in upcoming visits, and potentially eliminate costly prospective reviews.

Target High-Value Population for Provider CDI Training

Assess your patient population’s risk profile by identifying the Top 100 high-value ICDs, Top 40-50% providers, and Top 30 high-value HCCs to support a proactive, provider-level CDI training plan. This approach highlights the most risk-impactful diagnoses, enabling targeted chart reviews, targeted clinical actions, and smarter resource allocation to enhance care quality and optimize reimbursement.

Uncover Insights to Help Improve Coding Accuracy

Uncover valuable insights that highlight coding gaps, documentation inconsistencies, and high-impact diagnoses. These insights empower teams to improve coding accuracy and clinical documentation accuracy, support compliant risk adjustment, and enhance overall clinical documentation for better care quality and optimized reimbursement outcomes.

Here’s how our RAF Batch Score can help you:

EMR Platform Distraction

EMR platforms may flag HCC-linked ICDs every time a physician accesses a patient's chart, causing distractions. With our RAF tools, physicians can focus on HCC documentation once or twice a year, optimizing their time management and reducing distractions during every patient encounter.

Disease Interaction Risk Scores

RAF provides additional risk scores for disease interactions occurring within a single encounter. Our RAF Score tools identify ICDs causing interactions, enabling prompt assessment and confirmation within one encounter, enhancing efficiency and accuracy in risk adjustment.

Versatile Use Cases

RAF scores have diverse applications across healthcare providers and payer space, revenue cycle management, population health management, and Health IT product companies. From optimizing reimbursement processes to improving population health outcomes, RAF scores address a wide range of challenges and decision-making.

There are many more use cases where our RAF Batch scoring tool can be used.

Unlock your revenue potential today with RAF Score Batch and optimize your reimbursement process with confidence. Sign up for the free trial now!