A federal lawsuit claims that UnitedHealth Group, the largest Medicare Advantage insurer in the country, is coding medical claims inappropriately for monetary gain. But while the lawsuit doesn't ...

RAAPID's AI-powered risk adjustment solution received an A+ would-buy-again grade (Emerging Data, n=5) from interviewed ...

Faced with new government regulations, Medicare Advantage (MA) organizations should be utilizing technology to increase the accuracy of their coding, mitigate their risk, and ensure appropriate care ...

ELK RIDGE, Md.--(BUSINESS WIRE)--iQuartic (iQ), a NewWave company, is pleased to announce the launch of its leading-edge Risk Adjustment technology, the iQ SmartCoder. The iQ SmartCoder is a Visual ...

Change Healthcare has announced it is collaborating with Health Fidelity on a risk adjustment solution to provider greater accuracy for better compliance and more precise reimbursement. Health ...

Healthcare risk management solutions company Talix has launched Coding InSight for Payers. Coding InSight for Payers is designed to help health plans automate and streamline risk adjustment processes ...

Medicare Advantage plans and providers need to be aware of the recent increase in government enforcement of risk adjustment coding issues. In the past few years, the Office of the Inspector General ...

While technical in nature, risk adjustment is crucial to the future of health care transformation... If reforms to risk adjustment are to succeed, all of us concerned with the future of our health ...

The Medicare Shared Savings Program (MSSP) adjusts savings benchmarks by beneficiaries’ baseline risk scores. To discourage increased coding intensity, the benchmark is not adjusted upward if ...

How a California physician practice designed a system to catch coder errors without burdening doctors. Technology continues its climb toward what we would consider intelligence. Your average ...

More Medicare Advantage plans got star ratings of four or more for 2022 as some experts renew criticism of risk adjustment practices that can lead to greater quality performance.