what is the raf score for healthcare partners

Dynamic Healthcare Systems, a provider of innovative technology solutions for Medicare-focused health plans, today announced that Rocky Mountain Health Plans (RMHP) purchased its HCC Quick Assessment. Designed to maximize revenue for Medicare Health Plans, Dynamic’s HCC Quick Assessment allows RMHP to meet risk adjustment reimbursement requirements defined by the Centers for Medicare & Medicaid Services (CMS).

“We reviewed several technology solutions that would provide us with the ability to review and analyze our current RAF scores, and Dynamic offered the right combination -- a quick assessment and the expertise -- we were looking for to help us meet our September sweeps requirements,” said Patrick Gordon, Director of Medicaid and Medicare of Rocky Mountain Health Plans. “The ability to capture mis-coded ICD-9 codes and incorporate a solution in our system seamlessly, allowing us to manage our RAF score payments and maximizing our revenue potential is critical to us,” Gordon added.

”Dynamic’s HCC Quick Assessment identifies missing and mis-coded ICD-9 codes that have not been reported in qualified encounter data through the use of crosswalks and proprietary algorithms, thereby increasing program effectiveness and return on investment,” said Ken Stockman, founder and CEO of Dynamic Healthcare Systems, Inc. “Our goal is to provide comprehensive solutions that allow Medicare-focused businesses to maximize their revenue cycles and scale their membership without adding additional staff.”

Dynamic’s HCC Analytics module applies proprietary algorithms to qualified encounter data and unqualified secondary sources like, lab results, DME, and prescription encounters, to uncover suspected gaps in ICD-9 code reporting. Plans and MSOs use Dynamic’s work queues, detailed patient profiles and sophisticated report libraries to verify the suspects in medical records, document the actual outcomes and submit them to CMS.

About Dynamic Healthcare Systems

Dynamic Healthcare Systems, Inc. delivers comprehensive solutions for Medicare Advantage health plans and MSOs striving to succeed amid new and evolving regulatory requirements. Headquartered in Irvine, California, the company brings world-class innovations to companies serving the Medicare population. Dynamic Healthcare Systems can be reached at (949) 975-1877. www.dynamichealthsys.com.

About Rocky Mountain Health Plans

Rocky Mountain Health Plans (RMHP) provides medical benefit plans and services more than 188,000 enrollees. The organization was founded in 1974 and offers a wide range of medical benefit options, including PPO, HMO, shared-funding, and partially self-funded medical plans. It also provides health plans for Medicare and Medicaid-eligible persons and children who receive care under Colorado’s Child Health Plan Plus program. For more information, contact Rocky Mountain Health Plans at 800-843-0719 or visit www.rmhp.org.



Author Information

Grace Adams
DYNAMIC HEALTHCARE SYSTEMS INC.

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