Risk Adjustment
(RAF) Optimization
By ensuring every chronic condition is accurately captured and coded to the highest level of specificity, our clients typically see a 21% increase in their average RAF score within 12 months.
Trusted by Clinical Teams at Leading Healthcare Organizations Worldwide:
We Answer Your Critical Operational Questions.
Streamline administrative workflows and find answers to the bottlenecks slowing down your practice:
Why is my RAF score dropping even though my patients are getting sicker?
RAF scores reset every year. If chronic conditions aren't actively recaptured and documented annually with the highest specificity, your score and reimbursement will artificially drop.
How do I ensure we capture all HCC codes during the Annual Wellness Visit?
We provide prospective reviews and pre-charting support, giving your providers a clear, actionable checklist of suspected and historical conditions to address before the patient even enters the room.
Am I prepared for a RADV (Risk Adjustment Data Validation) audit?
Our retrospective audits rigorously check your documentation against MEAT (Monitor, Evaluate, Assess, Treat) criteria, ensuring every submitted code is fully supported by the clinical record.
How much revenue am I losing due to 'unspecified' diagnosis codes?
Unspecified codes often carry lower or zero risk weight. Our CDI feedback loop trains your clinicians to document the exact acuity and manifestations needed for maximum legitimate reimbursement.
How do I close documentation gaps before the final submission deadline?
We deploy a targeted concurrent review process, catching missing documentation and querying providers in real-time before the claim is ever submitted to the payer.
Direct Impact on your PMPM Reimbursement.
Risk adjustment isn't just about coding; it's about reflecting the true clinical complexity of your patient population. We provide the certified expertise to ensure your data matches your reality.
Average Client Result
Directly impacting Per-Member-Per-Month (PMPM) revenue through clinical documentation integrity.
Ready to optimize your revenue cycle?
Stop leaving money on the table. Get a free audit of your current workflow today.
Interested in our services?
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