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 Biden administration is proposing to increase Medicare Advantage (MA) and Part D plan payments by 1.03% for 2024 amid other changes to the programs’ risk adjustment model. The Centers for Medicare ...

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 ...

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 ...

NEW YORK CITY, NY / ACCESS Newswire / June 1, 2025 / As healthcare payers face intensified regulatory oversight, rising healthcare costs, and the evolving complexities of risk adjustment, Black Book ...

The Medicare Shared Savings Program (MSSP) adjusts savings benchmarks by beneficiaries’ baseline risk scores. To discourage increased coding intensity, the benchmark is not adjusted upward if ...

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.

Advanced Analytics, AI, and Automation Become Essential as Payers Face Increased Scrutiny on Risk Adjustment Accuracy and Financial Performance NEW YORK CITY, NY / ACCESS Newswire / June 1, 2025 / As ...