Risk Adjusted Payments & Identifying Discrepancies for Medicare Advantage Plans

The Wakely RAPID-M tool identifies and prioritizes encounter data issues that may adversely impact a Medicare Advantage (MA) plan. MA risk adjustment has recently undergone an important methodology change with more of the risk score based on medical encounter data over time (rather than RAPS data). The RAPID-M tool takes in ANSI 837 files along with RAPS information and is able to identify systematic differences and deficiencies in the encounter data that may result in substantial lost revenue.

For more information on RAPID-M, contact RAPID-M@Wakely.com.