The Hierarchical Condition Categories (HCC) system and Risk Adjustment Factor (RAF) scores are integral metrics developed by the Center for Medicare and Medicaid Services (CMS) to measure patients’ health conditions, estimate associated long-term treatment risks, and adjust reimbursement payments for healthcare providers.

RAF Optimizer™ is an AI-powered application designed to streamline and optimize the coding process in healthcare. RAF Optimizer™ assists healthcare providers in selecting the most appropriate diagnostic codes and HCC classifications for patients based on a sophisticated analysis of electronic medical records (EMR).

Key Benefits

  • Maximize Insurance Reimbursements: Enhances the accuracy of diagnostic codes and HCC classifications, aiding in the maximization of insurance reimbursements.

  • Improve Patient Care: With precise diagnostic coding, RAF Optimizer™ contributes to a better understanding and documentation of patient health conditions, leading to enhanced patient care.

  • Efficiency and Time Savings: Frees up valuable time for healthcare providers, enabling them to focus more on patient care.

Key Features

  • Evidence-Based Recommendations:  Provides evidence-based recommendations for the most appropriate diagnostic codes and HCC categories.

  • Seamless Integration with EMRs: The application easily integrates with existing EMR systems, allowing access to clinical records, notes, labs, and medications.

  • User-Friendly Interface: RAF Optimizer™ is designed with a user-friendly interface that simplifies the healthcare coding process, making it easier for providers to optimize HCC scores.