In fact, a September 2021 report from HHS’ Office of Inspector General highlighted potential concern around Medicare Advantage plan risk adjustment practices. The report found that 20 plans received ...
Your members are sicker than your risk scores reflect. Not because diagnoses don't exist—they're buried under unstructured data across fragmented systems. Every missed Hierarchical Condition Category ...
SAN MATEO, Calif., Dec. 19, 2017 (GLOBE NEWSWIRE) -- Apixio Inc., the data science company for healthcare, is enabling healthcare organizations across the country to gather a more accurate picture of ...
Noncompliant coding is a more significant risk to the revenue cycle than providers may realize, accounting for $36 billion in annual lost revenue, denials, and fines. In 2019 alone, the CMS and the ...
Faced with new government regulations, Medicare Advantage (MA) organizations should be utilizing technology to increase the accuracy of their coding, mitigate their risk, and ensure appropriate care ...
ATLANTA--(BUSINESS WIRE)--Vatica Health, the leader in provider-centric risk adjustment and clinical quality solutions, today announced another year of significant growth. Established in 2011, Vatica ...
Health insurers and stakeholders have expressed support for the Centers for Medicare and Medicaid Services' plan to phase in changes to the risk adjustment model over three years, in the 2024 Medicare ...
A growing range of policy discussions correctly assert that the current Centers for Medicare and Medicaid Services’ (CMS) risk-adjustment system needs modernization, reflecting its long history and ...
Optimizing risk adjustment would improve health equity, says the American College of Physicians (ACP) in a new policy paper published today. "Modernizing Risk Adjustment in Health Care: A Path to ...
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