Our Patient 1: On Day 1, RAF based score of this patient was 0.9 – Based on demographics for a 70-year-old Male ( age, sex, community vs. SNF, Medicare/Medicaid eligibility).
| Diagnoses per chart documentation | MRA Codes | RAF |
| Base | N/A | RAF 0.9 |
| Total RAF = 0.9 |
Based on an average per patient-per month payout of $1,000, baseline annual payout with comorbidity conditions:
0.9 x $1,000 x 12 mos. = $10, 800 per year
Our Patient 1: After initial review, MTC Health made following assessment: RAF base score 0.9, with more specific documentation of conditions and treatments.
| Diagnoses per chart documentation | MRA Codes | RAF |
| Base | N/A | RAF 0.9 |
| Alcohol Abuse | F10.10 | |
| CAD with Angina | I25.119 | 0.138 |
| BMI 38.59 (STARS) | None | |
| HTN | I10 | |
| Polyneuropathy | G62.9 | |
| Major Depression, single episode | F32.9 | |
| Smoker | F17.200 | |
| Unspecified Atherosclerosis | I70.9 | |
| Total RAF = 1.038 |
Based on an average per patient-per month payout of $1,000, baseline annual payout with comorbidity conditions:
1.038 x $1,000 x 12 mos. = $12, 456
Our Patient 1: After thorough assessment and document review, MTC Health transformed RAF based score 0.9 with the help of even more specific documentation of conditions and treatments.
| Diagnoses per chart documentation | MRA Codes | RAF |
| Base | N/A | RAF 0.9 |
| Alcohol Dependence, Uncomplicated | F10.20 | RAF 0.356 |
| Alcoholic Liver Disease | K70.9 | RAF 0.377 |
| CAD with Angina | I25.119 | RAF 0.138 |
| Pulmonary Hypertension | I27.20 | RAF 0.327 |
| Alcoholic Polyneuropathy | G62.1 | RAF 0.465 |
| Morbid Obesity (BMI 38.59 + CAD) | E66.01 | RAF 0.262 |
| Chronic Kidney Disease Stage 3 | N18.3 | RAF 0.035 |
| Major Depression, single, episode, mild | F33.0 | RAF 0.352 |
| Secondary Hyperparathyroidism (due to CKD Stage 3) | N25.81 | RAF 0.211 |
| Smoker’s Cough | J41.0 | RAF 0.332 |
| Atherosclerosis of Aorta | I70.0 | RAF 0.293 |
| Total RAF = 4.048 |
Based on an average per patient-per month payout of $1,000, baseline annual payout with comorbidity conditions:
4.048 x $1,000 x 12 mos. = $48,576
(Source: American Academy of Family Physicians)
The above example illustrates the significance of accurately coding and documenting MRA Codes. For this patient, MTC Health assessed reimbursements for this patient and the same increased by $48,576 per year.