RAF Score Optimization – CorroCare

Data processing engines and validation from HCC experts

CorroHealth provides a holistic risk adjustment solution that combines NLP technology, built-in workflow, and skilled professionals to manage the risk adjustment process.

Our CorroCare solution streamlines the processing and delivery of administrative and clinical data to CDI experts for pre and post-visit review. These teams then engage providers to close documentation gaps and reconcile said gaps against billing data to deliver RAF score integrity.

Automation for Critical Issues

Autonomous coding is designed to address:

Reconfirmation of previously claimed chronic conditions

Known conditions from problem lists

Suspect from labs and meds

Diagnosis previously documented but not billed

Inferred suspects delivered from clinical notes

Additional clinical evidence to help identify suspect conditions

The Validation Process

With key data compiled, CorroHealth experts work within the CorroCare platform for optimized HCC coding. The work performed includes:

Pre-visit review of identified gaps

Review and validate NLP identified conditions and suspects

Update problem list in the EMR

Alert provider within EMR workflow to documentation gap opportunities

Post-visit review and reconciliation

Review to ensure completeness of documentation post-visit

Reconcile against billing data to ensure accurate diagnosis

Reporting on gap closure and provider performance

Create RAF Score Improvement

The unique combination of a risk-based clinical data processing engine with the most trusted name in HCC coding has created significant results for our health system and health plan clients.

15%

9

20%

HCC + HEDIS

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