The Risk Adjustment arena in Healthcare
With the huge volume of health care data available today, it’s no thunderbolt that many health plans find themselves in the data array, lacking visibility to improving performance and speed around which members most urgently need care. While risk adjustment is a nexus process for all plan types, and each state has its own directives, exclusions, coefficients, and calculations, making it difficult to project revenue and schedule targeted care programs, a complete revamp or immediate shift to AI and NLP can be the game changer!
Revamping the risk adjustment process
Millions of medical charts are retrieved and reviewed manually each year to bring a more complete and comprehensive picture of members’ health status. Traditional risk adjustment or Risk score calculation methodologies lack the latest technology and tools to speed up the accuracy and efficiency. RAAPID uses NLP-powered artificial intelligence (AI) enabled solutions that are tried and tested on a lot of payers, to optimize their risk adjustment process.
Our Risk adjustment solutions
RAAPID technologizes the traditional chart review process by shifting the focus from volume to precision targeting of charts. The result is fewer chart retrieval requests, which lowers provider abrasion and increases the efficiency of each review. RAAPID’s risk assessment dashboard illustrates the impact of different diagnoses on the total Risk Adjustment Factor (RAF) score in real-time and includes recommendations for improvement. We provide some of the highest results around risk adjustment coding.
Our solutions provide flexibility to choose the services you need to be successful. RAAPID’s risk assessment dashboard illustrates the impact of different diagnoses on the total Risk Adjustment Factor (RAF) score in real-time and includes recommendations for improvement. We provide some of the highest results around risk adjustment coding, HEDIS abstraction, and retrieval.
Our technology is built to make customers’ experience positive, effective, and efficient. It works for you and you do not have to work around the technology. The goal of our technology is not to replace human interventions but to make human interventions smarter.