CMS HCC RAF Batch Scoring Tool for Pre-Prospective Coding

Drag and Drop your Excel file

or

*XLSX or CSV file only

  • Download “Excel Template” to populate your data.
  • Don’t use any PHI data. The maximum file size allowed is 500KB for XLSX files and 6MB for CSV files.
  • Choose the “Risk Model” and the corresponding “Risk Factor”
  • Drag and drop or Upload your excel file with data and click “Submit” button
  • Your input file will be processed and output file will be created in about 5-mins
  • Click “Download RAF Scores” to download the processed data

Download RAF Score

Sample RAF Scores Output
Download Excel Template

Select the Right High-Value Patient Charts and reduce the risk of major revenue loss with our RAF Batch Scoring Tool

Not all patients’ charts are released for prospective review, but it is typically about 30% of the patient population. Usually, Charts for prospective review are selected randomly, or by comparing current vs past FY claims by total revenue, and both these approaches could lead to high revenue charts being missed out causing major revenue loss. Our cutting-edge RAF Batch Scoring tool is specifically designed to look at your entire patient population and choose only the potential high-value patient charts for prospective review, ensuring maximum revenue generation for healthcare providers.

With the ability to analyze each ICD code meticulously and the interactions, our RAF Batch Scoring tool empowers provider organizations to select only high value for prospective review. Using the RAF Batch Scoring tool makes hospitals and health systems confident in selecting right patient charts for prospective HCC review and reimbursement.

One of the key challenges faced by providers is the uncertainty surrounding charts sent for prospective review, as not all of them guarantee high revenue. Investing significant time in prospective review and CDI to cover potential missed or new opportunities can be discouraging for physicians if the efforts do not yield additional revenue.

The proactive nature of our RAF Batch Scoring Tool enables you to prioritize high-value charts and patients for prospective review accurately. By ensuring that high-revenue charts are not missed out during random or traditional chart selection processes, our tool significantly reduces the risk of major revenue loss.

In addition to it, the tool advances retrospective review by comparing current vs. past FY claims data, offering a comprehensive understanding of the revenue impact. By combining data from both years, healthcare providers can identify potential revenue gains that might have been overlooked through traditional methods.

The tool processes each diagnosis code (ICD10) along with corresponding flags, Last_Year or Current_Year, to indicate the respective year to which the ICD10 belongs.

Don't rely on traditional methods that may miss out on critical revenue opportunities. Start using our RAF Batch Scoring Analysis Tool for prospective coding.