Results for Risk Adjustment

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  • Blogs

How Medicare Advantage Is Reshaping Revenue Cycle Management

Revenue cycle management used to feel more predictable for organizations serving Medicare patients. Traditional Medicare had its own rules, of course, but billing teams generally knew the workflow, the documentation standards, and the reimbursement structure they were dealing with. Medicare Advantage has changed that. As Medicare Advantage enrollment has grown, ...Read More
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  • Blogs

Are You RADV Audit Ready? Three Strategies to Get You There

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
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  • Blogs

Rev Up Your Revenue Cycle with AI

With profit margins shrinking and the cost of health care going nowhere but up, operational leaders and consultants throughout the healthcare industry are looking in every nook and cranny to either find ways to cut costs or generate more revenue. With the ongoing need for costly equipment, an expert workforce ...Read More
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  • Blogs

Strategies for Mastering Two-Sided Risk

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
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