Retrospective Risk Adjustment Solution
A quantum leap in risk adjustment accuracy, speed and value, beating all industry benchmarks.
Quality
(Final accuracy)
Productivity
(<8 Mins per chart review)
Guaranteed
ROI
Built for Risk-Bearing Organizations
Medicare Advantage & ACA plans
Provider-owned payers
Providers & Health Systems
Coding vendors & audit teams
Challenges in Risk Adjustment
Missed codes cut
revenue
Every undocumented HCC in retrospective reviews is lost reimbursement you can't recover.
Overcoding raises audit risk
RADV and OIG scrutiny intensifies with every code lacking MEAT evidence.
Timelines are
tight
Retrospective submission deadlines wait for no one, while HCC accuracy demands time.
Manual reviews
are costly
Traditional chart review processes drain resources & slow your entire operation.
From Traditional NLP to Novel Clinical AI Platform
Traditional Retrospective Vendors
Pick any two – fast, accurate, or affordable
- ✕ Manual review bottlenecks
- ✕ High error rates
- ✕ Expensive overhead
NLP-Only Solutions
Better than manual, still compromises
- – Improved speed
- – 20-30% accuracy
- – Limited clinical reasoning
RAAPID's Neuro-Symbolic AI
- ✓ ~5X productivity
- ✓ 92% out of the box accuracy
- ✓ 100% evidence trail
- ✓ 10X Guaranteed ROI
Quantum Leap in Defensibility
RADV Ready.
Every Time.
Ensure Audit Readiness
We've engineered audit readiness into every retrospective chart review. Our Neuro-Symbolic AI creates defensible documentation by design. Every HCC code links to MEAT evidence justification. Your retrospective audit defense is built in—not bolted on.
Comprehensive Audit Response
From notification to submission in record time. Our centralized command center for retrospective programs replaces your spreadsheet chaos with real-time tracking and one-click CMS-compliant reports.
Documentation Validation
Accuracy isn't luck—it's engineering. Every HCC code links to transparent MEAT evidence. No black boxes. No guessing. Just defensible retrospective documentation you can trust.
Eliminate Penalty Risk
Stop small errors from becoming millions in RADV penalties. Our Novel Clinical AI catches discrepancies before CMS does—protecting your retrospective revenue with audit-ready precision on every single chart.
Retrospective Risk Adjustment Solutions
Chase List Prioritization
- Prioritize members with the highest
HCC revenue opportunity - Stop chasing charts that won’t move
RAF scores - Reduce retrieval waste and
provider abrasion - Scale retrospective review capacity without
increasing overhead costs
Retrospective Risk Adjustment Reviews
- Capture every justified HCC code with MEAT evidence, prevent overcoding
- Meet retrospective submission deadlines without sacrificing accuracy
- Build RADV audit readiness with transparent documentation
- Scale retrospective operations without adding more coders
Quantum Leap Advantage
Beating Every Industry Benchmark
Industry Standard
Quality (Final Accuracy)
~95%
Out-of-the-box Accuracy
<30%
Chart Review Time
>40min
ROI Guarantee
None
RAAPID Performance
Quality (Final Accuracy)
98%
Out-of-the-box Accuracy
92%
Chart Review Time
<8min
ROI Guarantee
10:1
RAAPID Retrospective Risk Adjustment Workflow
Health Plans Choose RAAPID's Retrospective Solution
For Health Plans with
Provider Networks
Stop leaving money on the table. Our retrospective risk adjustment solution reviews 100% of your charts in days, not months—finding missed HCC codes while identifying unsupported codes before RADV audits catch them. Your providers stay happy with 60% fewer chart requests and faster, accurate payments. Every code backed by justified MEAT evidence.
For Provider-Owned
Payers
Your clinical, coding and CDI teams finally work in harmony. One retrospective solution eliminates the chaos of spreadsheets and emails with AI that achieves 98% HCC coding accuracy in under 8 minutes per chart. Built by former CMS auditors, our solution turns your biggest RADV audit risk into your strongest defense. Guaranteed 10:1 ROI.
Results That Transform Your Performance
Financial Impact
Revenue & RAF Uplift
$2500+Per member Appropriate Revenue Gain
10xGuaranteed ROI Delivered
Clinical Outcome
Proactive care reduces hospitalization/ER visits
4+ HrsWeekly hours saved by clinicians in documentation
60%+Reduction in chart review time
Compliance
Accuracy with audit-ready documentation support
100%Evidence-backed code justification
Delivery Options for Success
Platform + Services
We provide everything—our platform and our certified coders handle your entire retrospective program.
Platform Only
You get our technology. Your team does the coding. We provide the training and support.
AI as a Service
Connect our Novel Clinical AI to your existing systems. Keep your current workflow, add our speed and accuracy.
What Our Customers Say
Talk to Our Customers
Have a candid conversation with a risk adjustment leaders who broke free from the vicious cycle of time consuming reviews, missed revenue, and vendor chaos.
Success Stories
Real results from real customers
Risk Adjustment Program with
Novel Clinical AI
Frequently Asked Questions (FAQs)
RAAPID’s Novel Clinical AI Platform is the technology foundation that powers our retrospective risk adjustment solution. Think of it as an AI that reads medical charts like your best coder but works 5X faster. It finds HCC codes with 92% accuracy right away (improving to 98%), shows you exactly where each code comes from in the chart, and ensures every code has proper MEAT evidence—all in under 8 minutes per chart.
Traditional vendors using NLP-only solutions, which achieve only 70% accuracy, leaving millions in compliant revenue uncaptured while creating RADV audit exposure. Our platform solves three critical failures: poor accuracy, lack of transparent documentation, and unsustainable manual processes that drain resources.
Health plans achieve guaranteed 10X ROI through increased HCC capture (average $2,500 per member), reduced RADV penalties, and 60-80% productivity improvements. Your team’s process charts in under 8 minutes versus the industry’s 40+ minute average.
Implementation takes 4-6 weeks, including integration, configuration, and training, with flexible deployment via API, Azure, or SaaS. Unlike traditional solutions requiring months of model training, you start seeing results immediately.