REQUEST FOR INFORMATION (RFI) - Intelligent Coding Assistance Tool

The Centers for Medicare & Medicaid Services (CMS) is seeking information on intelligent coding assistance tools that can be integrated with Salesforce to improve the accuracy and efficiency of the HHS-Operated Risk Adjustment Data Validation (HHS-RADV) program. The tool should be able to consolidate medical chart/record values for diagnosis abstraction, populate initial review templates, and facilitate SVA primary coders and HCC validation. The primary goals of the tool are to reduce the time for medical coders to reach accurate conclusions, facilitate the review of medical charts/records more quickly and accurately, reduce burden and CMS costs, improve efficiency and performance, and demonstrate a financial and functional return on investment. Some key features of the tool include: • Ability to design, update, and refine data templates • Ability to scrape multiple data sources within the HHS-RADV Audit Tool • Ability to create multiple templates based on CMS needs • Ability to flag non-conforming or non-valid data inputs for remediation • Ability to make distinctions based on medical context and temporal reasoning • Ability for reviewers to see source input from data stored inside the HHS-RADV Audit Tool • Validations of data input • Error rate measurement and ability to see which medical codes were extracted by the ICAT