One Platform for All Compliance & Auditing Requirements I. Coding Audits: The Cornerstone of Compliance & Revenue IntegrityAccording to the Healthcare Financial Management Association (HFMA), lowering compliance risk and ensuring…
Client Background and Context National Health Plan with 3.5M+ members. The Fortune 500 client found gaps in their coding & claims data collection/submission process for a subset of their ACA…
Itโs been nearly 25 years since the United States government first began using risk adjustment in the Medicaid program and more than 20 since the country started using it in…
Even before the COVID-19 pandemic emerged last year, health care payers were facing numerous challenges. From rising costs and uncertainty about the Affordable Care Act (ACA) to struggles with systems…
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