01
Evidence Validation
Every HCC code checked against the supporting evidence in the record, so RAF is built only on conditions the documentation actually backs.
RAF Accuracy (V28)
eCareRevenue scores your RAF continuously against current CMS-HCC V28 model logic, so you always know your true risk-adjusted revenue, not an estimate built on outdated coefficients.
Every way eCareRevenue keeps your RAF accurate and defensible
Every capability that keeps your RAF score accurate, defensible, and ready for the day RADV comes.
02
Documentation Review
Documentation reviewed against MEAT criteria (Monitored, Evaluated, Assessed, Treated) for each condition, flagging gaps before they become RAF you can’t defend.
03
Audit Readiness
A RADV-ready audit trail built as you go, with chart evidence attached to every code, so you’re prepared before an audit is ever announced.
04
Claims Cross-Check
Submitted codes cross-checked against claims and chart data to catch mismatches, deletions, and unsupported HCCs before they distort your RAF.
05
Compliance Shielding
Only clinically-indicated, evidence-supported conditions surface, never upcoding heuristics, keeping your RAF accurate and your program compliant.
06
Risk Integrity
Continuous RAF scoring against current CMS-HCC V28 logic, with the V24-to-V28 impact visible across your population, so your risk score reflects reality, not stale coefficients.
The RAF accuracy and V28 scoring implementation journey
We guide you through four steps, from first connection to fully validated, audit-ready RAF scoring.
1
Connect EHR + Claims
SMART on FHIR + 837/835 claims via your clearinghouse. Connected in 1–3 days, with coded conditions and supporting evidence pulled together within five.
2
Calibrate & Baseline
We establish your RAF baseline against 24 months of historical claims and re-score it under current CMS-HCC V28 logic, so you see the V24-to-V28 impact on your population from day one.
3
Pilot & Train
A pilot group validates flagged codes against chart evidence, coders work a MEAT-backed review queue, and quality sees which conditions lack the documentation to hold up on audit.
4
Full Rollout + Measure
All clinicians, panels, and payer contracts go live. Your dashboard tracks RAF accuracy and audit-readiness across the population, quarter by quarter, with the V28 impact trended over time.
What RAF accuracy under V28 delivers, by the numbers
The accuracy, model alignment, and defensibility behind eCareRevenue’s RAF scoring.
+0.27
RAF lift, fully defensible
Cascade Health Partners ACO reached 1.21 with MEAT evidence on every code
CMS-HCC V28
Current model logic
RAF scored continuously on the active model, current, projected, and trended
100%
Codes evidence-backed
Every HCC validated against MEAT chart evidence before it counts toward RAF
V24 → V28
Full transition visibility
The exact impact of the model change shown across your population encounters
Frequently Asked Questions
Answers to the most common questions about how eCareRevenue keeps your RAF accurate and defensible under V28.
Every HCC code is validated against the evidence in the record, so your RAF is built only on conditions the documentation actually supports. Codes are also cross-checked against claims and chart data to catch mismatches and unsupported conditions before they distort your score.
Yes. eCareRevenue scores continuously against current CMS-HCC V28 model logic and shows your RAF current, and projected. You’re always aligned to the model that determines payment, not last year’s coefficients.
Yes, that’s a core use case. eCareRevenue re-scores your population under both models so you can see exactly where V28 moves your RAF, which conditions are affected, and how much revenue is at risk. You can plan around the change instead of discovering it at settlement.
Every code is linked to MEAT chart evidence like Monitored, Evaluated, Assessed, or Treated, so your audit trail is built as conditions are documented. If RADV comes, the support is already attached, and unsupported codes are flagged before they ever count toward RAF.
No, it’s the opposite. eCareRevenue only surfaces conditions that are clinically-indicated and supported by evidence in the record, and it flags codes that aren’t supported so you can correct them. The goal is an accurate RAF that holds up, not an inflated one that doesn’t.
Coding and CDI tools focus on capturing and documenting conditions. eCareRevenue adds the accuracy and defensibility layer on top, validating every code against evidence, scoring it on current V28 logic, and keeping the whole population audit-ready. It complements your CDI program rather than replacing it.
A 30-minute demo of V28 RAF scoring on a dataset like yours.
Book a session with our team. We’ll show V28 RAF scoring on data that matches your organization and answer every question before you decide.