Payer & Provider Solution

Transform Audit Data into Strategic Risk Insights at Scale

Calculate Pre-Audit and Post-Audit RAF scores, identify Medicare overpayments and underpayments, track trends at patient, provider, and population levels, and identify missed opportunities using historical data. Compare recaptured, yet to be recaptured, and suspect ICDs from prospective reviews while reducing documentation burden.

The RAF Batch Processing API enables healthcare organizations to calculate CMS-HCC risk scores for entire patient populations in a single operation. Our enterprise-grade API handles the complexity of batch processing, demographic adjustments, and HCC coefficient calculations with asynchronous processing, secure AWS S3 delivery, and HIPAA-compliant data handling—empowering your teams to prioritize high-risk interventions and optimize revenue accuracy.

For RAF score automation at the individual level, explore our RAF Score API. Learn more about RAF score calculation methodologies or browse our complete suite of healthcare APIs.

High-Volume Processing

Calculate thousands of RAF scores simultaneously with asynchronous batch processing

Secure Data Handling

No PHI in API requests—file-based submission with AWS S3 signed URL delivery

Comprehensive Results

Detailed RAF scores, HCC breakdowns, and demographic adjustments for every patient

Core Capabilities

What You Can Do with RAF Batch API

From patient risk stratification to provider training and coding accuracy validation, the Batch API powers critical risk adjustment workflows.

Pre-Audit & Post-Audit RAF Score Analysis

Utilize risk adjustment audit data to calculate Pre-Audit and Post-Audit RAF scores, identify Medicare overpayments or underpayments, and quantify audit impact on revenue.

RAF Score Trend Tracking

Track RAF score trends at the patient, provider, and population level to identify performance patterns, coding quality variations, and revenue trajectory over time.

Missed RAF Opportunity Identification

Utilize historical and current-year data to identify missed RAF opportunities associated with care gaps, reduce documentation burden, and prioritize high-risk patients for targeted interventions.

Prospective Review Data Comparison

Compare RAF scores of recaptured, yet to be recaptured, and suspect ICDs using prospective reviewed data to reduce documentation burden and prioritize high-risk patients.

Care Gap Detection & Documentation Optimization

Uncover missing diagnoses, documentation inconsistencies, and care coordination opportunities while eliminating redundant chart reviews across your patient population.

Secure Population-Level Processing

Process thousands of patient records without PHI exposure via secure file upload—no sensitive data transmitted directly through API requests or responses.

API Workflow

How Batch Processing Works

Six core features power the entire batch workflow—from file submission to secure result download.

1

Submit File for Processing

POST your CSV or JSON file containing patient demographics and diagnosis codes to the batch submission endpoint. Receive a unique job ID for tracking.

2

Check Processing Status

Query the status endpoint with your job ID to monitor batch progress—see pending, in-progress, completed, or failed states in real-time.

3

Download Results via S3

Once processing completes, receive a secure AWS S3 signed URL to download comprehensive RAF score results in CSV or JSON format.

4

OAuth2 Authentication

Enterprise-grade security with OAuth2 token-based authentication protecting all API requests and sensitive batch operations.

5

CSRF Protection

Cross-site request forgery protection ensures only authorized applications can submit and retrieve batch processing jobs.

6

Asynchronous Processing

Submit your job and continue operations—no need to maintain open connections while thousands of scores are calculated in the background.

Advanced Features

Enterprise Security & High-Volume Processing

Production-ready API infrastructure designed for healthcare data protection and population-level analysis.

Disease Interaction Risk Scores

Calculate risk impact of HCC disease interactions and coefficient adjustments across all CMS-HCC models (V24, V28, ESRD, RxHCC).

EMR Integration Ready

Seamlessly integrate with Electronic Medical Record systems, claims platforms, and care management applications via RESTful API.

Versatile Applications

Power population health analytics, RADV audit preparation, provider network optimization, and financial forecasting workflows.

Use Cases

Real-World Applications

Healthcare organizations leverage the RAF Batch API to drive operational efficiency, coding accuracy, and revenue optimization.

Pre-Audit & Post-Audit RAF Analysis

  • Pre-Audit and Post-Audit RAF score calculations
  • Medicare overpayment and underpayment calculation
  • Patient, provider, and population-level trends
  • Financial impact quantification

Historical Data & Missed Opportunities

  • Missed RAF opportunity identification
  • Care gap and chronic condition detection
  • Documentation burden reduction
  • High-risk patient prioritization

Prospective Review & ICD Comparison

  • Recaptured vs. Missed vs. Suspect ICD comparison
  • Pre-submission documentation gap analysis
  • Redundant chart review elimination
  • Prioritize high-impact patients
Technical Specs

Performance & Reliability

Enterprise-grade API infrastructure delivering reliability, security, and speed for population-level processing.

100K+
Records Per Batch

Process up to 100,000 patient records in a single batch operation

3
Simple API Endpoints

Submit, status check, and download—streamlined workflow for batch operations

REST
RESTful Architecture

Standard HTTP methods with JSON/CSV support for universal integration

S3
AWS S3 Delivery

Secure signed URLs for result download with automatic expiration

Start Batch Processing RAF Scores

Contact our team to learn how the RAF Batch Processing API can power your population risk analytics, retrospective audit strategy, and coding accuracy initiatives.

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