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Raapidai Xprt Software
5 software items found
by:Raapid.AI based inLouisville, KENTUCKY (USA)
Risk Adjustment program’s success completely depends on capturing complete member/patient risk. However, with stringent deadlines of CMS/HHS and high seasonal volume variability makes it difficult to handle large volumes of medical ...
by:Raapid.AI based inLouisville, KENTUCKY (USA)
There is a major crackdown on fraudulent or inaccurate risk-adjustment scores, with an increased number of RADV audits and OIG audits. Negative media attention and Lawsuits damaged the reputation. There is a need to shift processes to look both ways, stay compliant and get ahead of audits before they ...
by:Raapid.AI based inLouisville, KENTUCKY (USA)
A exquisite risk-adjustment solution is crucial to accurately lining up incentives and protecting risk-bearing healthcare providers and payers. Today, Risk Adjustment programs, including but not limited to, Medicare Advantage (MA), Affordable Care Act (ACA), Accountable Care Organizations (ACOs & ACO Reach), and Medicaid face challenges in getting timely access to clinical charts, claims, and ...
by:Raapid.AI based inLouisville, KENTUCKY (USA)
Prospective Risk Adjustment approach is the need of an hour as getting clinically validated actionable data in near real-time at the point of care reduces physician burnout and eliminates the requirement for costly retrospective chart chasing, QA and audits. However, shifting to Prospective approach is difficult and resource heavy using manual retrospective ...
by:Raapid.AI based inLouisville, KENTUCKY (USA)
Starting your risk adjustment program with the right subset of members to pursue risk-adjustable, high-value HCC opportunities with undocumented conditions can be a mammoth ...