Prospective Risk Adjustment Solution for Clinical Teams

Leverage AI to enhance care, optimize risk capture, and alleviate administrative burdens

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risk management

Accurate & Scalable Chart Review for Clinical Teams

In the modern healthcare landscape, the demands on primary care clinicians are escalating, often leading to burnout and decreased patient satisfaction. Amidst these challenges, RAAPID’s Prospective Risk Adjustment Solution emerges as a beacon of innovation. 

Our Solution analyze patients’ 360-degree longitudinal data, including charts, claims, lab reports, and pharmacy records, to identify chronic conditions and provide supporting MEAT evidence. It integrates seamlessly with Electronic Health Records (EHR) to ensure a smooth, accurate chart review process. As a result, clinicians can spend more quality time with patients, addressing their needs thoroughly rather than being entangled in administrative chores.

Pre-visit Prospective solution

RAAPID's Prospective Risk Adjustment Solution Brochure

Top Challenges Faced by Physicians, Nurses, and Administration Staff

Time Consumption

Time-Consumption

Traditional chart reviews can inefficiently use valuable time, often requiring hours of manual labor.

Training and Skill

Training and Skill

The need for more skilled nurses for chart review can lead to errors, exacerbating the administrative burden.

Quality of Care

Quality of Care

The cumbersome administrative tasks divert attention from patient care, potentially compromising the quality of healthcare delivery.

Data Overload

Data Overload

The overwhelming amount of data within EHRs can contribute to stress and burnout among physicians, nurses, and admin staff.

Prospective Risk Adjustment Solutions

Prospective Risk Adjustment

Pre-Visit Insights

Predict Risk Before Patients Arrive

✔ Identify care gaps proactively

✔ Surface hidden HCC opportunities automatically

✔ Prioritize high-risk members

Point-of-Care Gap Closure

Capture Complete Risk During Every Visit

✔ Real-time risk capture alerts in EHR

✔ Auto-suggest missing diagnoses instantly

✔ Full audit trail & justification for every suggestion

Retrospective Risk Adjustment
RADV Audit Solution

Post-Visit Concurrent Reviews

Validate Documentation Before Claims Submit

✔ Audit charts within 24 hours

✔ Flag incomplete documentation immediately

✔ Ensure coding accuracy pre-submission

Advantages of RAAPID’s Prospective Risk Adjustment Solution

Time Saving

Time-Saving

Slash chart review time by 60%, thanks to the AI-powered human-in-the-loop within an EHR-integrated workflow.

Reduced Burnout

Reduced Burnout

Minimize the administrative stress on your clinical teams, creating a conducive environment for quality care.

Elevated Care Quality

Elevated Care Quality

Analyze 360-degree longitudinal data, addressing care gaps and enhancing patient care experience.

Increase RAF Score

Increase RAF Score

By accurately capturing and documenting diagnosis codes, optimize the Risk Adjustment Factor (RAF) score, which leads to optimized Medicare reimbursement.

How it Works

HCC SAGE Works
HCC SAGE Works

Core Features

EHR Integration

Easily integrates with Electronic Health Records (EHR), to effectively review 360-degree longitudinal data, including charts, claims, lab reports, pharmacy records, and more.

EHR Integration
diagnosis code

Recapture Existing Chronic Conditions

Rediscover and manage known chronic conditions with precision and ease.

Suspect Care Gaps

Bridge the informational silos between past and present patient data, ensuring nothing slips through the cracks.

Suspect Care Gaps
Early Detection of Emerging Chronic Conditions

Early Detection of Emerging Chronic Conditions

Our solution uses Novel Clinical AI Platform ability to flag potential chronic conditions, enabling timely intervention by physicians.

Justification & Filtering with Evidence

Our Solution allows justification with evidence and customized filtering options.

Justification and Filtering with Evidence

Results That Transform Your Performance

Financial Impact

10%+

Revenue & RAF uplift

$2500+

Per member Appropriate Revenue Gain

10:1

Guaranteed ROI
Delivered

Clinical Outcome

10%+

Proactive care reduces
hospitalization/ER visits

4+ Hrs

Weekly hours saved by clinicians
in documentation

60%+

Reduction in chart review time

Compliance

98%

Accuracy with audit-ready documentation support

100%

Evidence-backed code
justification

We Safeguard Your PHI

i1 HITRUST
HIPAA COMPLIANT
SOC 2
Google Cloud
AWS
SOC
Microsoft azure
i1 HITRUST
HIPAA COMPLIANT
SOC 2
Google Cloud
AWS
Microsoft azure

Client Testimonials

"I have been using RAAPID's Prospective Solution for my patient’s diagnosis coding practice management since it first came out and absolutely love how user-friendly, comprehensive, and intuitive the system is. The ability to easily upload new codes quickly helps me stay up-to-date with ICD-10-CM coding changes so that I can provide accurate patient care. Highly recommend!"
- Mary K.Clinical Administrator
"The RAAPID's Prospective Software has been a great asset to our healthcare management practice. It provides us with an easy way to manage ICD-10-CM codes and quickly identify care gaps in our patient population. The customer service from the team is also top-notch, always helping us whenever we have questions or issues."
- Tony O.Doctor
"I recently started using RAAPID's Prospective Risk Adjustment Solution to manage my ICD-10-CM coding and it has been a great help. The practice management solution is incredibly user-friendly and the care gap analysis feature helps me make sure I am taking full advantage of all available codes. It's made my job much easier!"
- Raj B.Clinical Documentation Specialist

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FAQs related to HCC SAGE Prospective Previsit Solution

HCC SAGE is designed to seamlessly integrate with your existing EHR system, enhancing its functionality without disrupting current workflows.

HCC SAGE employs a robust blend of Artificial Intelligence (AI), Machine Learning (ML), and Natural Language Processing (NLP) to ensure accurate and efficient chart review.

Automating the review of charts, claims, lab reports, pharmacy records, and more.  HCC SAGE significantly reduces administrative workload, allowing clinicians to focus more on patient care and less on tedious tasks.

HCC SAGE accurately identifies and recaptures existing conditions and suspects care gaps and overlooked chronic conditions, which assists in optimizing Risk Adjustment Factor (RAF) scores.

To provide a comprehensive pre-visit risk assessment, HCC SAGE analyzes 360-degree longitudinal data, including charts, claims, lab reports, pharmacy records, and more.