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Reads clinical indicators in claims, labs, and charts to flag emerging suspects so physicians can act.
RAAPID reads clinical indicators in claims, labs, and charts to flag emerging suspects so physicians can act.
Platform
(prospective to RADV)
Integration paths
(FHIR, HL7, APIs, SFTP)
Output categories
(emerging suspects to deletes)
Works with any EHR. Connect through FHIR, HL7, or a simple file transfer.
RAAPID connects labs, symptoms, and medications across the chart to flag conditions never documented or claimed.
Illustrative
Before the visit · RAAPID
Hypertension, two eGFR results below 60, no kidney diagnosis.
Suspected CKD stage 3, linked to both labs.
Illustrative
At the visit · Physician acts
Physicians override more than half of EHR alerts. Suspect prompts land in the same inbox, and the undiagnosed condition sitting in the labs never reaches the visit.
Every vendor wants its own portal, its own feed, and its own integration project. Physicians will not leave the EHR, and security will not approve another unmanaged tool.
From CY 2027, CMS excludes diagnoses from unlinked chart review records. A condition not confirmed in a visit will not move your risk score.
A short, curated list per visit, each suspect with the labs, symptoms, and medications behind it. The physician confirms or rejects with a reason. Nothing is coded without a face-to-face encounter.
Suspects appear in the chart physicians already work in, and accepted conditions write back. Standards your team already supports, and no rip-and-replace.
A diagnosis confirmed in the encounter is linked by design, so it moves the risk score when unlinked chart review no longer does. Targeting puts review effort where findings are likely.
Data comes in from the systems you already run, the platform suspects from clinical indicators, and the
results land where physicians and leaders act.
Charts, notes, labs, medications
Encounter and eligibility data
Cloud storage, warehouse, or file transfer. Bidirectional.
Reads the full chart; every suspect backed by clinical indicators
Member prioritization across the MA and ACA population
EHR integration and PDFs; accept or reject at the visit
Campaigns, drill-downs, adoption by practice
Available as a SaaS application or API
What changes when suspects come with clinical indicators
~90K suspects across 257K members, surfaced in under two weeks at one regional provider-owned health plan.
Physicians can't scan years of labs, notes, and medications for every patient. Conditions hiding in the data go unaddressed.
Chronic conditions must be documented again each year. The ones not revisited quietly drop off, and so does the accuracy of your risk scores.
Lists arrive from every health plan and EHR prompt, most without evidence. Physicians need one list they can act on, with the proof attached.
RAAPID brings one reviewed list to each visit, with the evidence behind every suspect.
Charts, claims, labs, and pharmacy data come in; your reviewers curate what reaches each physician.
Charts pulled only where findings are likely
Each condition shown once, hierarchies applied
Review rules and coding guidelines set per program
Batched to each physician's schedule, curated first
Illustrative
Ready
1 suspect
2 gaps
1 gap
1 suspect
1 add
No findings
Findings appear in the workflow physicians already use, with one click to the evidence behind each.
Accept and document, or reject with a reason
Anything not addressed carries to the next visit
Nothing coded without a face-to-face visit, per RADV
Rejection reasons improve each physician's list
Illustrative
In your EHR
True suspect
Historical
RAAPID checks the finalized chart against the claim and the physician’s decisions, before the claim goes out.
Unclaimed and unsupported codes flagged
Missing MEAT routed to CDI
Accepted at the visit but never documented, caught
Acceptance, rejections, and RAF accuracy by physician
Before submission
Ready
Review
Add
Remove
To CDI
RAAPID gave our organization a clear view of code gaps across our entire population, including conditions no one had documented before. Our physicians now go into each visit with a reviewed list of suspects and the chart evidence behind each one, and nothing is coded unless they confirm it. Closing code gaps is now part of the visit, not a year-end chase.
Access the full list of chronic conditions and key updates.
Strategies to close HCC gaps, keep coding accurate, and protect reimbursement.
Code gaps, unclaimed conditions, unsupported codes, and emerging suspects. You choose what reaches physicians.
A chronic condition never documented or claimed, inferred from labs, symptoms, and medications. Only the physician can confirm it.
No. Start with the step you’re missing and add the rest later.
Charts, claims, labs, pharmacy, and radiology from the last two years plus the current year, via EHR integration or file transfer.
Under two weeks for 257K members at one health plan.
Your pre-care nurses or coders, or RAAPID’s experienced coders. Your choice. Physicians only see the validated list.
Start with one practice of employed providers. Watch the acceptance dashboard, then extend to independent groups with your own adoption data in hand.
A walkthrough on sample charts, set up your way.
Potential value
Results from one regional provider-owned health plan, in under two weeks. Potential revenue at 50% provider confirmation.
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What Our Customers Say
“RAAPID gave our organization a clear view of code gaps across our entire population, including conditions no one had documented before. Our physicians now go into each visit with a reviewed list of suspects and the chart evidence behind each one, and nothing is coded unless they confirm it. Closing code gaps is now part of the visit, not a year-end chase.”
VP, Provider-Owned Health Plan
“We needed suspecting emerging conditions in front of our providers during the encounter, with the evidence right there. RAAPID reviewed our population, and every suspect came back linked to the chart evidence behind it, with a multi-million dollar potential benefit for our plan.”
“Our coding team does not like change but our coders and auditors love the collaboration with RAAPID. They feel like you are part of our coding team.”
Talk to Our Customers
Have a candid conversation with a risk adjustment leader whose physicians now close suspect conditions in the visit, not at year-end.
Real results from real customers
By a Regional Provider-Owned Health Plan
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