Get accurate HCC Risk score analysis: Discover Medicare HCC RAF Score Analysis for Actionable Risk Adjustment
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Are you struggling to prioritize which diagnosis codes require better documentation for accurate reimbursement?
Are physicians ignoring your clinical document improvement recommendation?
Do you lack insights into the revenue impact of billed, missed, and new diagnosis codes?
Do you need a comprehensive revenue impact analysis with high-revenue, low-revenue, and no-revenue diagnosis codes?
If your answer to any of the above questions is yes, you need to read this further.
If you're a Medicare-eligible provider, you're likely aware of the importance of claiming reimbursements for your Medicare patients through Fee for Service claims. But did you know that you may also be eligible to claim additional revenue through risk adjustment using the same Fee for Service data?
Many healthcare systems across the country are missing out on significant revenue by neglecting risk adjustment. Well, don’t worry. Our Medicare HCC RAF Score Analysis tool, designed for medical coders, is here to help you begin your journey toward greater revenue through revenue impact analysis for concurrent, retrospective, and prospective reviews.
RAF Score is known for its complexity, limiting its usage among medical coders and provider organizations. Our Medicare HCC RAF Score Analysis tool has simplified RAF Score utilization. It is quick and easy to use, and its revenue benefits are huge.
But what is risk adjustment, and why is it so important for providers?
Risk adjustment is a method used by the Centers for Medicare & Medicaid Services (CMS) to ensure that payments to Medicare Advantage (MA) plans are appropriate based on the health status of their enrollees. The MA plans to receive a monthly payment from CMS for each beneficiary enrolled in their plan, and this payment is adjusted based on the health status of the beneficiaries.
Accurate HCC risk score analysis is crucial in different types of coding to ensure optimal revenue capture and documentation practices.
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Our Medicare HCC RAF Score Analysis tool, designed for medical coders, enhances post-prospective coding by determining the need for clinical document improvement and providing revenue insights for prioritizing diagnosis codes.
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For retrospective reviews, only around 10% of patient charts are randomly released, but by performing revenue impact analysis on the combined data from current and past financial years can lead to significant increased revenue. Our HCC risk score analysis tool identifies high-value charts for HCC review based on individual ICD analysis, calculates accurately the revenue impacts, and uncovers missed documentation opportunities.
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During post-retrospective coding, Medicare HCC RAF score analysis guides decisions on resubmission or dropping of charts, ensuring optimal revenue outcomes for high-value charts, and avoiding the operational cost of resubmission and follow-ups for low-value charts.
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In pre-retrospective coding, our tool identifies high-value charts and potential revenue gains across different financial years.
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In post-concurrent coding, HCC risk analysis helps medical coders identify missed opportunities and generate effective provider education reports with potential revenue and HCC risk score.
By incorporating accurate RAF score analysis, healthcare providers can enhance revenue capture, streamline coding processes, and improve documentation practices, leading to improved financial outcomes and overall coding efficiency.
Here are some of the benefits of using HCC RAF Score Analysis tool:
Our tools allow providers who are not currently doing risk adjustment to analyze their Fee for Service claims data from the previous year and current year and identify opportunities for increased revenue.
Increased Revenue Opportunities:
Our HCC risk score analysis tool allows providers to analyze their Fee for Service data and identify opportunities for increased revenue. By capturing and documenting the full extent of a patient's medical conditions, providers can ensure appropriate reimbursement.
Ongoing Revenue Impact Analysis:
Whether providers are already involved in risk adjustment or not, our tool enables them to perform continuous prospective and concurrent revenue impact analysis. This helps to accurately identify the revenue opportunity for missed, billed, and new diagnosis codes.
Prioritization and Documentation Improvement:
Our tool not only identifies revenue opportunities but also helps providers prioritize which diagnosis codes to focus on for documentation improvement. By following HCC MEAT guidelines, providers can target those diagnosis codes and accurately document a patient's medical conditions.
Detailed Revenue Impact Report:
With our tool, providers can easily download comprehensive revenue impact report that highlight high-revenue, low-revenue, and no-revenue diagnosis codes.
Maximize your Revenue Impact Analysis with our advanced HCC RAF Score Analysis Tools
By sharing our RAF score and accurate revenue impact details as part of your CDI recommendations and provider education report, you can significantly improve the confidence of physicians.
By leveraging the RAF Score Analysis tool, you can confidently identify charts that have the greatest impact on revenue, allowing for strategic decision-making during prospective reviews.
Our RAF Score tools analyze new or modified ICDs and provide RAF score and revenue opportunities, and it enables us to decide whether a chart should be sent for resubmission or not.
Our RAF Scoring tools enable you to prioritize the charts with the highest RAF Scores and revenue impact and it can mitigate the risk of missing out high-value charts.
With RAF Score Analysis, you can elevate the confidence in your provider education report by giving accurate recommendations for high-priority and low-priority diagnoses based on RAF scores and revenue impact.
Important note:No need to sign-up or sign in to start trying RAF score analysis tool. Click the above “Try it!” to start experiencing our tool. If you're not logged in, you'll only be able to use our tool a specified number of times per day. To use the tool more frequently, you'll need to sign up for an account.
Subscription Plans:
You can choose a suitable subscription plan according to your requirements. The subscription plan of NPI Data Services for Medicare HCC RAF Score Analysis is as follows:
Medicare HCC RAF Score Analysis - Subscription Plan & Pricing
Try our "Risk Adjustment revenue impact analysis" tool free for 30 days. No credit card is required.
| Price Plans | Trial Free | Starter $20/month | Pro $25/month |
|---|---|---|---|
Duration |
1-month | 12-months | 12-months |
No. of User Account |
1 | 1 | 1 |
Searches/day |
10 | 50 | 75 |
No. of RAF Scores/day |
300 | 2500 | 3750 |
| Revenue Impact Analysis | |||
Post-Prospective HCC Coding |
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Pre-Prospective HCC Coding |
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Post-Retrospective HCC Coding |
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Pre-Retrospective HCC Coding |
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Post-Concurrent HCC Coding |
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| CMS-HCC Risk Model | |||
Continuing Enrollee |
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New Enrollee |
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C SNP |
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| RxHCC Risk Model | |||
Continuing Enrollee |
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New Enrollee |
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| ESRD Risk Mode | |||
Continuing Enrollee |
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New Enrollee |
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Price |
Free | $20/month | $25/month |
We offer an annual subscription that is both cost-effective and easy to use. With this subscription, you will receive a set number of daily hits each day for an entire year. Any unused daily hits will expire at the end of each day, so you can be sure you're getting the most out of your subscription.
Heres what you need to know:
Searches per day:
Each time a user submits a search on the Medicare HCC RAF Score Analysis portal, it counts as one search. The maximum number of searches allowed per day is limited.
RAF Scores per day:
The number of RAF scores that can be retrieved per day depends on factors such as the number of diagnosis codes included in each search, validation flags, and interactions among the diagnosed conditions. The maximum number of RAF scores that can be retrieved per day is also limited.
Once the daily limit for either searches per day or RAF Scores per day is reached, no further searches can be conducted. If you decide to cancel your subscription at any time, please note that we have a no-refund policy. Your current subscription will expire at the end of the expiry date. Payment is required in advance.
If you subscribe partway through a month, we will pro-rate the subscription for that month and extend it for a full 12 months from the start date. For example, if you subscribe on March 12th, your subscription will expire on April 30th of the following year. The pro-rate will be based on the annual subscription rate. If you want to renew your existing subscription, you can renew it by logging in to your account or by contacting us.
Every healthcare provider should encourage their medical coders to use our HCC RAF Score Analysis tool as part of the coding workflow to have significant revenue impact. Don't stay away from “Risk Adjustment” and leave money on the table when it comes to Medicare reimbursements. Try our "Risk Adjustment revenue impact analysis" tool using your Fee for Service claims data and discover your potential risk adjustment revenue.
Sign up now for the free trial or select a suitable subscription plan for your requirements.