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How Tech-Driven Tools are helping healthcare payers accurately map the population’s risk burden?

Risk Adjustment for healthcare payers and providers determines the coverage rate for patient care and accurately maps the population’s risk burden. But, have you adopted the modern AI-Driven Risk Adjustment solution for the clinical chart retrieval and review process?

A well-crafted risk-adjustment solution is pivotal to properly lining up incentives and protecting risk-bearing healthcare providers and payers.

Today, the healthcare payers sector perceives the Internet of Medical Things (IoMT), AI-powered tools, as one of the next-generation healthcare payer technology trends.

In addition, AI is also helping healthcare payers and providers adopt automation and efficiency for multiple administrative workflow within the healthcare ecosystem.

Do technological tools have an impact on patient care?

AI, being the top digital health trend increases the ability of healthcare payer industry professionals to better understand the day-to-day patterns and needs of the individuals they care for. With that understanding, they are able to retrospect and offer feedback, guidance, and support to lead a healthier life.

For a health care payer and provider to ensure its population’s risk burden is accurately mapped, exquisite technology tools must be used to monitor encountered data, segregate aberrancies, and quickly and efficiently address any errors, if any.

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Advantages of Artificial Intelligence in Healthcare

Artificial Intelligence (AI) is proving to be the most harnessed form of technology that is being adopted by multiple industries including payers in healthcare. Considering the healthcare industry, through AI, payers can analyze large clinical data with enhanced precision to identify inconsistencies and unusual data patterns.

Overall, it eliminates the chances of human errors.

Benefits of RAAPID.AI for healthcare payers and providers

The AI-empowered big data and analytics solution allows a workflow in real-time to review medical charts, select the right codebook and ensure a three-click chart review process to facilitate structured chart routing.

Key benefits:

  • Deliver tangible, time-saving operational efficiencies to your provider network. Precise prediction and prioritization enable fewer charts to be requested because its AI can be configured to automatically exclude charts for those unreported diagnosis codes before their retrieval.
  • Its analytics feature ease chart retrieval workflow by identifying retrieval modalities, aligned with provider preferences.
  • Maximize coding efficiency, accuracy, and completeness.

Summing up

RAAPID’s AI-Enabled Analytics solution can transform your chart review operations because it’s been tested with large amounts of data. It upgrades you from the traditional chart review process to precision targeting of charts, resulting in fewer chart retrieval requests.


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Disclaimer: All the information, views, and opinions expressed in this blog are inspired by Healthcare IT industry trends, guidelines, and their respective web sources and are aligned with the technology innovation, products, and solutions that RAAPID offers to the Risk adjustment market space in the US.