Medicare Advantage coding requires a lot of attention to detail, and submitting inaccurate diagnoses for reimbursement could be a compliance nightmare, according to an article from AAPC, a ...

Medicare Advantage plans reimburse providers based on hierarchical condition categories. Here are the “top 10” coding errors for MA risk adjustment, according to an article from AAPC, a professional ...

Artificial intelligence (AI)-enabled tools such as natural language processing (NLP) have been integrated into a wide range of applications, including risk adjustment coding tools, for greater ...

The best way for insurers to make sure they're in compliance with the mandates of risk adjustment is to use natural language processing for accurate documentation and auditing, according to Dr. Calum ...

Medicare open enrollment kicked off Friday with more Medicare Advantage plans to choose from but with renewed criticism that insurers are gaming risk adjustment practices to inflate profits. While ...

SAN FRANCISCO, Oct. 8, 2020 /PRNewswire/ -- Innovaccer, Inc., a leading healthcare technology company, has launched its Risk Adjustment Solution. Leveraging Innovaccer's industry-leading, FHIR-enabled ...

Claims data, which form the foundation of risk adjustment in payment for health care services, may reflect efforts to capture more—or more severe—clinical conditions rather than true changes in health ...

To maximize shared savings, mastering risk adjustment is a critical factor for Accountable Care Organizations (ACOs) participating in MSSP, ACO REACH, and other alternative payment models.

The Alliance of Community Health Plans is calling out risk adjustment scores by larger insurers in Medicare Advantage plans. ACHP, an organization that advocates for smaller health plans, said the ...

LOUISVILLE, Ky., Feb. 28, 2025 /PRNewswire/ -- RAAPID, an AI-powered risk adjustment technology leader, will present critical insights on modernizing RADV audit preparation, sharing real-world results ...

Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with Penguin Ai's HCC Coding & Risk Adjustment Snowflake Native App PALO ALTO, Calif., Jan.