Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...

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 ...

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 ...

Payers stratify premiums for a given benefits package by the member's relationship to the policy holder, and if permitted, by age or gender. This stratification discourages enrolling higher-risk, ...

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 ...

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 ...