Risk-Based Programs

Program Compliance, Program Support, and RAF Score Integrity

CorroHealth provides scalable approaches to evaluate, support, and enhance risk-based programs. We apply over a decade of experience in Medicare, Medicaid and Commercial Risk Adjustment through combinations of a 3,500+ global member team and strategic technologies.

Program Compliance

CorroHealth assists with program compliance & quality efforts through auditing, abstraction, and reviews. This includes HCC coding audits, second level chart reviews, and HEDIS chart abstraction.

Program Support

Program support is delivered with prospective, concurrent, and retrospective HCC coding. Flexibility is delivered from our 3,500+ professionals with the ramping for HCC season and reduction of support as needed.

RAF Score Integrity

Deployment of our full RAF Score Integrity solution combines NLP technology, built-in workflow, and skilled professionals to manage the end-to-end risk adjustment coding process. Our technology streamlines processing and delivery of administrative and clinical data to CDI and HCC Coding experts for pre and post-visit review. These teams then engage providers at the point of care to close documentation gaps, reconcile gaps against billing data and perform high-quality HCC coding via medical records to deliver RAF score integrity.

Strength with Security and Accountability

  • 3,500+ professionals
  • 13+ years expertise in Medicare, Medicaid and Commercial Risk Adjustment
  • 11M+ medical records reviewed annually
  • HIPAA, ISO 27002, and SOC 2 TYPE II compliant
  • Dedicated audit teams for each project
  • 100% adherence to client and regulatory guidelines
  • 48-72 hour TAT across all processes
  • >95% HCC Coding Accuracy
  • Weekly and monthly business review reports
  • Feedback loop and refresher training
  • Continuous and transparent best-in-class audit processes to ensure quality & accuracy commitments are met or exceeded
  • Flexible & customized operating structure based on client needs
  • All coders proficient on ICD-9 & ICD-10

Exceeding Financial Health Goals

15% to 20%

RAF Score Improvement