Clinical Intelligence/Clinical Efficiency

RAAPID Launches AI-Powered RADV Audit Solution for Health Plans

RAAPID Launches AI-Powered RADV Audit Solution for Health Plans

Health Plans Can Access Complete RADV Audit Solution Today – Live Demo at RISE West

RAAPID, a leading provider of AI-driven risk adjustment and compliance solutions, today announced the launch of its comprehensive RAAPID RADV Audit Solution. This offering is specifically designed to equip health plans with the tools and expertise needed to confidently address the Centers for Medicare & Medicaid Services’ (CMS) intensified Risk Adjustment Data Validation (RADV) audits.

Live Demonstration at RISE West: See the Solution in Action

Conference attendees will experience firsthand how RAAPID’s solution transforms RADV audit preparation and defense. The demonstration will showcase:

  • Real-time Audit Workflow Management: Watch how the platform eliminates spreadsheet chaos by centralizing all audit activities in one intelligent console, complete with automated alerts and progress tracking.
  • AI-Powered Chart Review in Action: See RAAPID’s Neuro-Symbolic AI instantly analyze medical charts, identify HCC codes, and provide explainable evidence trails that stand up to CMS scrutiny.
  • Mock Audit Simulation: Experience a compressed timeline of an actual RADV audit cycle, from initial notification through final response submission.

At RISE West, we’re not just talking about AI – we’re showing exactly how it solves healthcare’s most expensive compliance challenge,” said Chetan Parikh, CEO of RAAPID. “Attendees will see our platform process actual de-identified charts, validate HCC codes, and generate audit-ready documentation in minutes, not months.”

Meeting Healthcare’s Most Urgent Compliance Challenge

With CMS projecting $4.7 billion in RADV recoveries and implementing universal annual audits, health plans face unprecedented financial risk. The new audit framework demands perfect documentation and zero coding errors – a standard impossible to achieve through manual processes alone.

A Dual-Powered Approach for End-to-End RADV Audit Management

RAAPID’s approach combines technology and expertise through:

  1. Audit Management Tool: An intelligent workflow platform that serves as a management console for RADV audits. Health plans gain complete visibility into audit status, automated task assignment, and proactive risk alerts. Optional AI capabilities can be activated to supercharge internal workflows.
  2. AI Audit Solution: The full-service solution pairs RAAPID’s clinical AI technology with certified RADV auditors who bring direct CMS audit experience. This combination automates chart reviews, validates HCC codes, generates comprehensive audit reports, and manages rebuttals.

Flexible Deployment for Every Audit Scenario

The platform addresses two critical use cases that will be demonstrated at RISE West:

  1. RAAPID Audit Defense: For plans currently under CMS audit, the solution provides immediate support to build defensible responses and minimize recoupments. Conference attendees will see how the platform analyzes charts and claims to create bulletproof audit documentation.
  2. RAAPID Audit Readiness: For proactive organizations, the platform conducts mock audits to identify vulnerabilities before CMS comes knocking. The RISE West demo will show how plans can assess their audit risk and close documentation gaps in advance.

“What makes our solution unique is the perfect balance of AI speed and human expertise,” explains Wynda Clayton, Director of Risk Adjustment at RAAPID and former CMS RADV Auditor. “At RISE West, we’ll demonstrate how our certified auditors use explainable AI to ensure every code is clinically accurate and fully defensible. This isn’t black-box technology – it’s transparent, traceable, and trustworthy.”

Immediately Available

The RAAPID RADV Audit Solution is available starting today, August 26, 2025. Early adopters will receive priority implementation support, customized training, and direct access to RAAPID’s RADV experts to prepare for the upcoming audit season.

The platform meets all enterprise security requirements with HIPAA, SOC2 Type II, and HITRUST certifications, ensuring complete data protection throughout the audit process.

Visit RAAPID at RISE West

Stop by the RAAPID booth #313 at RISE West to schedule a personalized demonstration and learn how your organization can transform RADV audit preparation. The RAAPID team will be available throughout the conference to discuss specific audit challenges and demonstrate relevant solution capabilities.

Explore AITechPark for the latest advancements in AI, IOT, Cybersecurity, AITech News, and insightful updates from industry experts!

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