Healthcare coding has fundamentally transformed from volume-driven revenue capture to compliance-first, defensible documentation standards.
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 ...
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 ...
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 ...
Does AI hold up in retrospective risk adjustment once real customers put it to work? KLAS Research went and asked. RAAPID was ...
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 ...
BELLEVUE, Wash.--(BUSINESS WIRE)--Edifecs, Inc., a global health information technology solutions company, today announced Point of Care Suspects, expanding its comprehensive Risk Adjustment offering ...
RAAPID's AI-powered risk adjustment solution received an A+ would-buy-again grade (Emerging Data, n=5) from interviewed customers in the May 2026 KLAS Emerging Company Spotlight, citing AI accuracy ...
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 ...
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 ...
Medicare Advantage is the dominant Medicare delivery system, now covering 54% of all Medicare enrollees. With the increase in enrollment and federal spending, however, has come increased scrutiny from ...
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