Protect Your RAF. Defend Your Documentation. Maximize Medicare Revenue.
Independent Medicare Risk Adjustment Audits that Identify Missed Revenue and Reduce RADV Exposure
Example of Impact
Identify 20-30% additional clinically supported conditions in typical audits.
Audit Services
Driving accuracy, compliance, and RAF performance.
Retrospective Audit & Validation
- Comprehensive chart review aligned with CMS guidelines
- Identify missed, unsupported, or mis-coded diagnoses
- Validation of HCC capture and coding accuracy
Provider Education & Documentation Integrity
- Targeted provider feedback based on audit findings
- Education on MEAT criteria and compliant documentation
- Specialty-specific training to improve RAF capture
RADV & Compliance Readiness
- Preparation for RADV and payer audits
- Identification of high-risk documentation gaps
- Defensible coding practices aligned with CMS expectations
Prospective Review & Opportunity Capture
- Identify undocumented conditions prior to submission
- Improve current-year
RAF accuracy
- Close documentation gaps before they become risk
Data Analytics & RAF Insights
- Identify coding trends and RAF opportunities
- Provider- and population-level performance reporting
- Actionable insights to drive RAF performance
Program Strategy & Advisory
- RAF program design and optimization
- Workflow and operational process improvement
- Strategic support for ACO, MSSP, and MA programs