LOUISVILLE, Ky., Feb. 28, 2025 /PRNewswire/ — RAAPID, a leader in AI-driven risk adjustment technology, will present its solutions for modernizing RADV audit preparation at the RISE National conference on March 13, 2025, at 11:15 AM (CST). The company will highlight the impact of its AI technology in mock audit preparation and share real-world results.
Attendees can learn more about RAAPID’s purpose-built AI solutions at Booth #513, where the RAAPID leadership team will be available to meet with visitors.
Transforming RADV Compliance: An AI-Driven Approach
In a featured speaking session titled “Transforming RADV Compliance: How AI-Driven Technologies Are Revolutionizing Risk Adjustment Audit Preparation,” RAAPID’s team of experts will address the growing compliance challenges faced by risk-bearing entities. Importantly, the RISE National agenda already includes sessions by the Office of Inspector General (OIG) and the Department of Justice (DOJ).
With CMS now applying extrapolation to audit years retroactively to 2018, Medicare Advantage (MA) plans face significant financial exposure without proper preparation. Moderated by Michael Clark, President & Chief Growth Officer at RAAPID, the discussion will feature Wynda Clayton, Consultant in Risk Adjustment and a former RADV Auditor, and Nehal Shah, CTO at RAAPID and CEO of DataOrb. The session will explain how healthcare organizations can proactively use AI technologies to gain coding insights and transition from reactive to proactive compliance management.
“The updated extrapolation allowances coming in 2025 create urgent challenges for risk adjustment teams,” explained Clark. “Our session will show how AI-powered tools can help organizations maintain continuous coding accuracy, dramatically reducing variance while lowering costs, increasing the audit pool, and lowering overall administrative burden.”
Key Areas of Focus
The presentation will cover three main areas crucial for healthcare organizations:
- AI-Powered Compliance Infrastructure: This section will address how purpose-built Risk Adjustment AI and DocumentAI technologies work together to maintain coding accuracy and aid audit preparation.
- Year-Round Audit Readiness: This section will explore practical strategies for identifying where variance occurs and implementing proactive compliance management.
- Navigating Regulatory Changes: This section will address current DOJ and OIG priorities and demonstrate how technology-enabled preparation addresses emerging compliance requirements.
RAAPID’s solutions help healthcare organizations bridge the gap between payers and providers by employing Knowledge Graph-infused AI technology trained on millions of real clinical charts. The company’s AI platform maintains high levels of accuracy, consistently achieving an accuracy level in the high 90s, well above the accepted industry standard of 95% accuracy in risk adjustment coding while ensuring appropriate reimbursement capture.
Visitors to Booth #513 at RISE National will have the opportunity to see RAAPID’s solutions in action, including demonstrations of the company’s Prospective Pre-Visit Solution, point-of-care and post-visit workflows, and Retrospective Review and Audit capabilities. The RAAPID leadership team will be present throughout the conference to discuss the challenges facing attendees and their organizations.
For healthcare organizations concerned about RADV compliance, the expansion of audit extrapolation, and maintaining accurate risk scores, RAAPID provides proven solutions that work within existing clinical workflows.
About RAAPID
RAAPID is a leading provider of AI-driven risk adjustment and compliance solutions, offering evidence-based and audit-proof coding accuracy for both health plans and providers. Having recently secured backing from M12, Microsoft’s Venture Fund, RAAPID is advancing the capabilities of clinically-explainable AI to help organizations confidently navigate Medicare Advantage, Managed Medicaid, and ACA risk adjustment programs.
For more information, visit www.raapidinc.com/events/rise-national-2025.
Contact:
Mayur Vyas (502) 699-3044 [email protected] (502) 498-4018
