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Client Background and Context Client with 20+ risk-bearing locations & various data input sources wanted to: Partner with a platform to audit codes received from multiple sourcesImprove productivity of each of their locations & divisionsIncrease data quality of codes added by internal & external partnersEnhance operating margins through cost optimization Solution ...Read More
The Centers for Medicare and Medicaid Services (CMS) recently announced plans to ramp up its risk adjustment data validation (RADV) audit program in 2020 based on a recent study by the Office of Inspector General (OIG), which found potential issues related to Medicare Advantage Organizations (MAOs) using chart reviews to ...Read More
Population health and the transition to two-sided risk is no easy feat – it’s a monumental shift in the way providers, payers and hospitals think about the delivery of health care. And, while, we all know it’s coming – knowing how to get there and doing it successfully is the ...Read More
By Nitin Thakor, GeBBS President & CEO There is much discussion today on what is going to happen to the Medicaid program. Congressional Republicans and President Trump are seeking to repeal and replace the Affordable Care Act (ACA) and Medicaid is a large part of that program. Medicaid has been ...Read More