🚦 RAF Score Basics: What Compliance Grading Really Means

 Most providers know about RAF scores. Few understand that they drive how payers grade your compliance. Since 2007 Precision has helped build these systems — so we know how to make them work for you.

👉 If medical necessity is found, providers must act — regardless of payer.
Fee-for-service. Capitated. Cash pay. Care is care.

1. Risk Stratification
📊 What risk do payers see in your patient panel?

2. Comparative Outcomes
📈 How do your results compare to peers with similar risk profiles?

3. Care Connectivity
🔗 Do you close the loop on medically necessary services, inside and outside your practice?

4. The Path to Better Scores?
🎯 Fix #2 + #3 → #1 improves automatically.

💡 Stealth Workflow Intelligence runs in the background:

• Finds & fixes care gaps
• Connects services
• Never clogs your workflow
   

✨ Result: Higher compliance scores. Better payer trust. Healthier patients.

1. $333,901 Lost – CMS said care was needed. Provider didn’t act.
2. Compliance Fail – 16 Quality Measures require 60%. Most providers hit only 2–4.
    

1. AI-HRA to the Rescue – Every patient screened, risks flagged, services auto-connected in the background.
2. Track It All – Offers, enrollments, and declines are logged (yes, even “no” counts toward compliance).
    

1. 100% Screening Offered
2. 100% Medical Necessity Met
3. 100% Compliance Achieved
    

1. Billable Encounters – Every step generates revenue.
2. Painless & Automatic – Compliance and revenue run in the background while you focus on care.

1. 🏥 Two Hospital-Based Family Practices – you’d think they have the resources to succeed.
    
2. 💸 Missing $5,612,336 – that’s $206,717 per provider or $588.86 per patient in mandated services!
    

1. Hospitals Should Do Better – with built-in support, these losses are a conservative estimate.
    
2. ✅ Pilot Proof – our One-Time Compliance & Health Records Engagement Pilot delivered $248,625 for 2,500 patients ($99.45 each).
    
3. 🔎 Hidden Opportunity – even after the Pilot, $489.41 per patient is still missed.
    

1. One Simple “YES” – employed physicians = instant turnaround.
    
2. 🍎 Low Hanging Fruit – hospitals are the largest employer of physicians, making this the easiest win.