RAAPID Inc., a Microsoft M12-backed company specializing in AI-powered risk adjustment, has introduced an enhanced retrospective risk adjustment platform. This platform, driven by its proprietary Novel Clinical AI engine, aims to automate retrospective reviews, delivering over 92% out-of-the-box accuracy and up to 98% with final coder validation, alongside 60-80% productivity gains for coding teams.
The launch addresses challenges faced by health plans and health systems regarding RADV audits and retrospective chart reviews. RAAPID’s solution leverages Neuro-Symbolic AI technology to provide a transparent and explainable audit trail with precise clinical evidence for each suggested HCC code. This design offers a defense against audits and seeks to ensure payment aligns with population needs.
Chetan Parikh, CEO of RAAPID, stated, “We are delivering 92%+ out-of-the-box accuracy—not an incremental gain, but a significant improvement over the industry’s 20-30% accuracy. Health plans and health systems can finally stop drowning in manual chaos and start commanding their entire risk adjustment program with confidence, backed by defensible accuracy.” He emphasized that the platform empowers clients to transform their risk adjustment operations and support value-based care initiatives.
The solution directly targets multi-million-dollar RADV audit clawbacks. By establishing a single source of truth with MEAT-based evidence for every code, RAAPID aims to achieve defensible accuracy that can withstand strict audits, potentially driving a revenue and RAF uplift of 10% or more.
The company highlights key benefits, including achieving over 92% coding accuracy out of the box, a productivity gain of 5x or more, and reducing per-chart review time from 30-40+ minutes to under 8 minutes. The platform’s transparency provides explainable, auditable evidence for each code, which is intended to build confidence and protect against RADV clawbacks.
Michael Clark, President & Chief Growth Officer of RAAPID, commented, “This evolution represents our commitment to future-proofing risk adjustment. We’re giving our clients’ expert teams their lives back, transforming them from data cleaners into strategic leaders who focus on what matters most.” He added that the enhanced platform delivers capabilities previously unseen in the industry.
The RAAPID platform is HITRUST-certified and integrates seamlessly via cloud-based APIs. As a Microsoft Pegasus partner, it offers deployment options directly within clients’ Azure environments, designed to ensure that Protected Health Information (PHI) remains under the organization’s control. Health plans and health systems can schedule a demo via the company’s website.
RAAPID Inc. develops AI-powered risk adjustment solutions for healthcare payers, providers, and supporting organizations. Its HITRUST-certified platform uses neuro-symbolic AI to identify chronic conditions, determine HCC codes, calculate risk scores, and analyze population health trends. Following a Series A investment from M12 (Microsoft’s venture fund), RAAPID serves organizations participating in Medicare Advantage, ACA, Medicare ACO, and Medicaid programs. The company, founded by healthcare technology veterans, is headquartered in Louisville, Kentucky.
