In this tutorial, we’ll walk you through the steps required to use the Medicare Advantage Risk Score Calculation API. We’ll demonstrate how to send a request to the API and receive the calculated risk score using the CMS-HCC Model.

Prerequisites

Before starting the tutorial, make sure you have:

• An API key or authentication credentials (if required)
• A client application to send requests to the API

Step 1: Import the necessary namespace

First, import the namespace containing the models for the API in your application.

using Cortex.OpenApi.Models;

Step 2: Create a RiskCalculationRequestModel object

Next, create a RiskCalculationRequestModel object and populate its properties with the required demographic details and diagnosis codes.

RiskCalculationRequestModel requestModel = new RiskCalculationRequestModel
{
    Demographics = new DemographicsModel
    {
        AgeAsOfFebPaymentYear = 65,
        SexForClinicalUse = SexForClinical.Male,
        DisabledStatus = false,
        MedicaidEligibility = false
    },
    DiagnosisCodes = new List<DiagnosisCodeWithUscdiClass>
    {
        new DiagnosisCodeWithUscdiClass { DiagnosisCode = "E11.9", UscdiClass = "Condition" },
        new DiagnosisCodeWithUscdiClass { DiagnosisCode = "I10", UscdiClass = "Condition" }
    },
    PaymentYear = 2023
};

Step 3: Implement the CalculateRiskScoreAsync method

Create a method called CalculateRiskScoreAsync that sends a request to the API with the RiskCalculationRequestModel object and returns the calculated risk score.

private async Task<double> CalculateRiskScoreAsync(RiskCalculationRequestModel requestModel)
{
    // Replace with the actual API endpoint URL
    string apiUrl = "https://api.example.com/api/risk-score";
    
    // Serialize the request model to JSON
    string jsonRequest = JsonConvert.SerializeObject(requestModel);

    // Send a POST request to the API with the JSON request
    using (HttpClient client = new HttpClient())
    {
        // Add any necessary headers (e.g., authentication)
        client.DefaultRequestHeaders.Add("Authorization", "Bearer YOUR_API_KEY");

        // Create the HTTP content with the JSON request
        HttpContent content = new StringContent(jsonRequest, Encoding.UTF8, "application/json");

        // Send the request
        HttpResponseMessage response = await client.PostAsync(apiUrl, content);

        // Ensure the request was successful
        response.EnsureSuccessStatusCode();

        // Deserialize the response to a double value
        string jsonResponse = await response.Content.ReadAsStringAsync();
        double riskScore = JsonConvert.DeserializeObject<double>(jsonResponse);

        return riskScore;
    }
}

Step 4: Call the CalculateRiskScoreAsync method and display the result

Finally, call the CalculateRiskScoreAsync method with the RiskCalculationRequestModel object and display the calculated risk score.

double riskScore = await CalculateRiskScoreAsync(requestModel);
Console.WriteLine($"Calculated Risk Score: {riskScore}");

That’s it! You’ve successfully used the Medicare Advantage Risk Score Calculation API to calculate a risk score using the CMS-HCC Model.