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White paperNovember 1, 2024

Pre-Bill RAF & Denial Prevention: Stop Revenue Loss Before Claims Are Submitted

Why conditions documented today still fall out during review and how leading MA, ACO, and MSO teams reduce RAF volatility by validating documentation before it matters.

RAFRisk AdjustmentDenial PreventionRADVDocumentation Quality

What’s inside

A practical framework for preventing RAF loss that happens quietly when documentation exists but doesn’t hold up during review, reconciliation, or RADV.

  • Why conditions are documented but later invalidated during chart review.
  • How HCCs drop during reconciliation and why teams discover gaps too late to fix them.
  • What makes documentation audit-defensible vs. merely MEAT-complete.
  • How to validate documentation before submission, without adding review burden.
  • How leading organizations reduce RAF volatility and operate audit-ready year-round.

Ready to see it in action?

We help ACOs, MSOs, providers, and payers catch what slips through the cracks before claims leave the building. Learn how we can help.

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