The Complex Effects of COVID-19 on Risk Adjustment Strategy
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…
How AI, NLP Technologies Automate Risk Adjustment Processes
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…
Natural Language Processing in Risk Adjustment Coding โ Itโs Not Just for Over-Reads
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,…
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…
Concurrent Coding Review for Risk Adjustment โ Why โCleaning As You Goโ Works in Healthcare, Too
If youโve ever worked in a restaurant or commercial kitchen โ you know one of the golden rules is to โClean as You Go.โ Employing a โClean As You Goโ…