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 ...

LOUISVILLE, Ky., May 16, 2022 (GLOBE NEWSWIRE) -- The RAAPID risk capture platform is actively taking medical coding to the desired leap of accuracy and profitability with its unique usage of ...

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 ...

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 ...

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’ ...

Capturing accurate diagnostic codes through comprehensive risk adjustment programs has become increasingly important for provider-sponsored health plans to improve patient care and clinical quality.

George Witwer, CEO of Cavo Health Outperforms Machine Learning Tools with 96%+ HCC completeness, 2–4x Productivity Gains and Reduced Audit Risk Our platform delivers more accurate, audit-ready results ...

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 ...

Tara Bannow covers hospitals, providers, and insurers. You can reach Tara on Signal at tarabannow.70. Health insurers in the private Medicare business have a big incentive to diagnose their members ...

As stay-at-home orders are lifted and states begin to reopen, healthcare is starting to get into the rhythm of a “new normal” with COVID-19. Patient volumes are beginning to rebound, particularly ...