Florida Medical Group Reduce Diagnosis Gaps and Unlock $2,320 Financial Outcomes Per Member
A multi-location value-based medical group transformed prospective coding with AI-driven pre-visit planning, unlocking $11.6 million in revenue through defensible coding while making coders 5x more productive.
Manual pre-visit processes, missed RxHCC codes, CMS V28 transition concerns, and lack of EHR integration limited revenue and operational efficiency.
Solution Overview
AI-driven prospective pre-visit platform analyzed longitudinal clinical data using NLP and a 60-million-entity knowledge graph. Seamless NextGen EHR integration enabled automated care gap identification and V24/V28 coding adaptability, ensuring every code has evidence that stands up to audit defence.
Key Outcomes
- $2,320 revenue unlocked per member
- 50% reduction in coder review time
- $11.6M new revenue across 5,000 members
- Defensible submissions with evidence that withstands audits
Client Testimonial
“We were amazed to see the accuracy of RAAPID’s AI-powered prospective pre-visit coding solution. Our Coders achieved 5× productivity gains, with 100% of codes directly linked to defensible clinical evidence.”
— VP of Risk Coding, Florida-Based Multispecialty Medical Group