Medicare Advantage plans and providers need to be aware of the recent increase in government enforcement of risk adjustment coding issues. In the past few years, the Office of the Inspector General ...

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 ...

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.

Review Proposed Changes for Medicare Advantage Plans in 2024 Discuss the change from Version 24 to Version 28 and the impact on Risk Adjustment Calculation Methodology Explain how Fee-for-Service will ...

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 ...

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 ...

Inaccurate HCC coding can lead to significant financial implications and variability in Risk Adjustment Factor scores. A new infographic released by PYA illustrates why coding accuracy is paramount ...

Attendees at the upcoming RISE Summit with questions about risk adjustment will have plenty of options to learn from the experts during the three-day event at the Omni Nashville Hotel. Sessions ...

Cotiviti, a leader in enterprise healthcare software and data-driven technology solutions, will present and exhibit at the ACDIS Conference and Symposium (April 19--23) in Chicago, Illinois and the ...

The MarketWatch News Department was not involved in the creation of this content. Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with ...