Client Background and Context National Health Plan with 6M+ members of which 1M+ MA. The client found gaps in their coding & claims data collection/submission process. The client wanted to: Overcome…
Risk Adjustment programs are here to stay as we move into a value-based world. With reimbursement for health plans and providers tied to these programs, ensuring they are lean, efficient,…
As if 2020 wasn’t overwhelming enough for payers who are battling a global pandemic while navigating all the many changes it brings to policies and reimbursement – there’s also a…
Payers and healthcare providers alike are in the constant pursuit of the triple aim in healthcare – including better quality, greater value, and improved patient satisfaction – as the shift…
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