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 ...
The Medicare Advantage (MA) risk-adjustment system increases and decreases MA plan payments based on the health risks of their enrollees. The current system assesses health risk based on Hierarchical ...
Accurate HCC coding is critical for patient risk adjustment, as it directly impacts reimbursement models and financial sustainability in value-based care. However, studies indicate that as many as ...
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 ...
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 ...
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 ...
NASHVILLE, Tenn.--(BUSINESS WIRE)--Change Healthcare today announced that it is collaborating with Health Fidelity, Inc. to offer a risk adjustment solution that embeds natural language processing ...
Talix has entered into a reseller agreement with NextGen Healthcare, Allscripts and Capstone Performance Systems to make Talix's risk-adjusted coding solution available to customers on the companies' ...
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