API Catalog Overview
VBC Risk Analytics provides a suite of production-grade healthcare APIs designed for risk adjustment workflows. The API catalog includes RAF Score API (real-time and batch), ICD-10 Code Lookup API, ICD-10 Guideline Auditor API, NPI Lookup API, and RADV Scrubber API.
All APIs use RESTful architecture with JSON request/response formats, OAuth 2.0 authentication, and sub-200ms response times for single-record queries. Batch endpoints support 10,000-100,000+ records per request with overnight processing.
Integration Patterns
EHR Integration: Embed real-time RAF scoring and HCC gap alerts directly in clinical workflows. The RAF Score API accepts patient demographics and ICD-10 codes, returning risk scores with care gap analysis in under 200ms.
Population Health Platforms: Use batch APIs for overnight processing of full member rosters. The RAF Batch API handles 100,000+ member records per batch with V28, V24, ESRD, and RxHCC model support.
Claims Processing: Integrate ICD-10 Guideline Auditor into claims editing workflows for pre-submission compliance validation. The API validates coding guidelines against 140+ pages of CMS rules in real time.
Authentication and Rate Limits
All APIs require OAuth 2.0 bearer token authentication. Tokens are issued via the /auth endpoint with client credentials grant. Rate limits are set at 1,000 requests per minute for real-time endpoints and 10 batch requests per hour for bulk processing. All data transmission uses TLS 1.2+ encryption, and all APIs are HIPAA-compliant with BAA available.
Three downloads risk adjustment teams actually use
Checklists, playbooks, and frameworks — built for analysts, auditors, and VPs working RAF, RADV, and HCC.
2026 RADV Audit Readiness Checklist
12-point compliance checklist for documentation, diagnosis code validation, extrapolation defense, and pre-audit scrub workflows.
RAF Score Optimization Playbook
Tactical guide for analysts: HCC recapture workflows, V28 transition impacts, prospective gap-closure plays, and KPIs that move RAF lift.
Risk Adjustment Analytics Playbook
How payer leaders sequence prospective and retrospective risk adjustment for compounding RAF lift. Deployment patterns, KPIs, and a VP-level operating rhythm.