Real Nurse Solutions is a privately owned and run company by a seasoned Registered Nurse and a Certified Clinical Documentation Specialist dedicated to helping healthcare providers with their documentation and denial needs. Although our office is located in Hawaii, we are set up to work remotely and can work with clinicians across the United States. Documentation: I will assess and identify gaps and make recommendations, that will increase your Risk Adjustment Factor Scores (RAF Scores). Denials-We will assess, write the appeal (utilizing references to argue payers inconsistencies), communicate with payers (clinician to clinician), monitor appeal deadlines.