RAF Best Practices: A Year-Round Checklist for Chronic Condition Support

1. Pre-visit prep: surface hidden risk

Don’t let risk hide in the chart. Equip schedulers and care coordinators with tools that surface untreated or unaddressed HCCs before the visit.

• Prioritize face-to-face visits for high-risk patients whose RAF dropped versus last year.
• Create smart flags for patients with a risk gap against baseline.
• Review social determinants that may require longer visits or extra documentation support.

2. During the visit: enforce MEAT evidence

RAF depends on documentation. Train teams to avoid passive mentions and ensure proper assessment language and plan linkage.

• Embed MEAT prompts in workflows for providers, scribes, or coders.
• Block submissions when MEAT is not present for risk-adjusted conditions.
• Capture supporting labs, meds, vitals, and imaging at the point of drafting.

3. Post-visit drafting: get it right the first time

Coding teams shouldn’t rebuild drafts from scratch. Use AI-assisted drafting tools that highlight missing risk codes, modifiers, and evidence.

4. Mid-year check-in: spot RAF drift early

Waiting until Q4 to sweep missed HCCs is too late. Run monthly gap analyses and monitor provider-level variance to course-correct before scores lock.

5. Year-end wrap: prepare for CMS and payer reviews

Ensure every RAF-driving condition is tied to audit-ready evidence. Reconcile denials before year-end submission and run internal audits focused on specificity and panel drift.

Bottom line: compliance is a by-product of clarity

With the right tools, your teams can code confidently, reduce denials, and protect shared savings without extra stress.