CMS HCC RAF Batch Scoring Tool

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

Streamline the process of identifying high-value charts with revenue potential and receive the accurate reimbursement.

Our innovative Risk Adjustment Factor Score Analysis Tool for prospective coding revolutionizes the way healthcare providers conduct chart reviews, maximizing revenue potential and optimizing clinical document improvement efforts.

With comprehensive features designed to prioritize high-value charts and patients, as well as generate Provider Education Reports with Risk Adjustment Factor scores and Revenue Opportunities, our tool for prospective coding empowers healthcare professionals to make informed decisions that positively impact their top line.

Our tool streamlines the process of identifying high-value charts with revenue potential after prospective coding for physician’s review. Leveraging current FY claims data, our medical coders analyze and recommend missed opportunities for clinical documentation improvement, focusing on key areas like severity, laterality, specificity, and the cause-and-effect relationship between conditions. By identifying areas for better documentation, our RAF Batch scoring tool ensures that no revenue-generating opportunity goes unnoticed.

Physicians often invest significant time and effort into clinical document improvement to cover missed opportunities, but not all new ICDs provide substantial revenue gains. Our tool pinpoints which ICDs have the potential to impact revenue positively or minimally during after prospective coding review. By providing this crucial insight, our RAF Batch Scoring Analysis Tool for prospective coding empowers physicians to focus on the areas that will yield tangible financial rewards, mitigating the risk of losing interest due to inadequate returns.

Our RAF Batch Scoring tool takes and reports the data with the following tags for better analysis of revenue opportunities and RAF Score for medical coders:

  • Diagnosis codes from the current financial year are flagged as Billed.
  • Diagnosis codes from the past financial years are flagged as Missed.
  • Diagnosis codes with MEAT but missed earlier and identified during the HCC coding are also flagged as Missed.
  • Diagnosis codes recommended by a medical coder with potential revenue opportunities are flagged as New.