Best-in-Class Solutions
Augment In-House
Operations
- Artificial Intelligence
- Accessibility
- Cybersecurity
- Financial Technology
- Project Management
Industry Leading Know-how
Advance Regulatory Proficiency
- Medicare Part C & D
- 508/WCAG Compliance
- Payment Oversight & Audit Readiness
- Revenue Management
- Program Integrity
Technology Innovations
Leverage the Powerful
RaLytics Platform
Medical Record Evaluation
Evaluate and identify vulnerable medical record documentation for internal compliance, provider education and training, and mitigating audit risk by oversight entities.
Payment Cycle Optimization
Optimize payment by identifying gaps between patient encounters and medical record documentation to improve beneficiary management and reimbursement accuracy.
Claims Anomaly Detection
Score claims documentation for likelihood of support or reimbursement, generating input for further analysis or corrective actions.
Who We Serve
Improving the
Healthcare System
for Everyone
RaLytics’ overarching goal is providing unique solutions and technologies to improve the Medicare Advantage system for everyone.
RaLytics solutions help improve the Medicare Advantage risk adjustment ecosystem for Payers, Providers, and the vendors who support them.
We’re turning burden into opportunity for stakeholders, enabling them to grow and adapt in a changing healthcare system.
Streamlining Program Reimbursement
& Compliance
Put Artificial Intelligence, Interoperability & Analytics into Action
The RaLytics platform, underpinned by policy-driven algorithms, reduces burden by streamlining transfer and evaluation of medical records while providing previously unavailable insights.
Contact Us to Learn More
Ready to Get Started?
RaLytics is excited to show you how our solutions can work for your organization. Please contact us to get started on improving your RADV experience.
Keeping You Informed
Latest News & Articles
RaLytics Comments on the 2024 ACA Proposed Rule
In response to the notice of benefit and payment parameters for ACA published by HHS, RaLytics has a number of suggestions on how to ensure the ACA risk adjustment process is more efficient and equitable for everyone.
RADV Final Rule
CMS has published its final rule for Medicare Advantage risk adjustment data validation, codifying a number of changes with far-reaching ramifications for MAOs.
The 2018 MA RADV Proposed Rule
In anticipation of CMS publishing its final Medicare Advantage risk adjustment data validation rule, there are a number of key issues from the agency’s earlier proposed rule from 2018 to keep an eye on.