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 is a lost reimbursement you can't recover.
Overcoding raises audit risk
RADV and OIG scrutiny intensifies with every unsupported code.
Timelines are
tight
Submission deadlines wait for no one, while accuracy demands time.
Manual reviews are costly
Traditional processes drain resources & slow your entire operation.
From NLP to Novel AI
Traditional
Pick any two Fast, accurate, or affordable – never all three.
- ✕ Manual review bottlenecks
- ✕ High error rates
- ✕ Expensive overhead
NLP Only
Better than manual, still compromises.
- – Improved speed
- – 20-30% accuracy
- – Limited clinical reasoning
RAAPID 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.
Audit Readiness Engineered In
We've engineered audit readiness into every chart review. Our Neuro-Symbolic AI creates defensible documentation by design. Every code links to MEAT evidence justification. Your audit defense is built in—not bolted on.
Comprehensive Audit Response
From notification to submission in record time. Our centralized command center replaces your spreadsheet chaos with real-time tracking and one-click CMS-compliant reports.
Documentation Validation
Accuracy isn't luck—it's engineering. Every code links to transparent MEAT evidence. No black boxes. No guessing. Just defensible documentation you can trust.
Eliminate Penalty Risk
Stop small errors from becoming millions in penalties. Our AI catches discrepancies before CMS does—protecting your revenue with audit-ready precision on every single chart.
Retrospective Risk Adjustment Solutions
Chase List Prioritization
- Prioritize members with the highest revenue opportunity
- Stop chasing charts that won’t move RAF
- Reduce retrieval waste and provider abrasion
- Scale review capacity without increasing overhead costs
Retrospective Risk Adjustment Reviews
- Capture every justified code, prevent overcoding
- Meet submission deadlines without sacrificing accuracy
- Build audit readiness with transparent documentation
- Scale 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
For Health Plans with
Provider Network
Stop leaving money on the table. Our AI reviews 100% of your charts in days, not months—finding missed HCCs while deleting unsupported codes before RADV audits catch them. Your providers stay happy with 60% fewer chart requests and faster, accurate payments. Every code backed by transparent MEAT evidence.
For Provider-Owned
Payers
Your clinical, coding and CDI teams finally work in harmony. One platform eliminates the chaos of spreadsheets and emails with AI that achieves 98% accuracy in under 8 minutes per chart. Built by former CMS auditors, our solution turns your biggest 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
Turn Data into Action and insights for Risk Adjustment and Value-Based Care
