With upcoming changes under health reform and pressures to gain revenue, healthcare institutions must make risk-adjustment training a must for all stakeholders, according to Joy Ridlehuber, senior ...

NASHVILLE, Tenn.--(BUSINESS WIRE)--Change Healthcare today announced that it is collaborating with Health Fidelity, Inc. to offer a risk adjustment solution that embeds natural language processing ...

A growing range of policy discussions correctly assert that the current Centers for Medicare and Medicaid Services’ (CMS) risk-adjustment system needs modernization, reflecting its long history and ...

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 ...

Payers stratify premiums for a given benefits package by the member's relationship to the policy holder, and if permitted, by age or gender. This stratification discourages enrolling higher-risk, ...

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 ...

Your members are sicker than your risk scores reflect. Not because diagnoses don’t exist—they’re buried under unstructured ...

Talix has entered into a reseller agreement with NextGen Healthcare, Allscripts and Capstone Performance Systems to make Talix’s risk-adjusted coding solution available to customers on the companies’ ...

Medicare open enrollment kicked off Friday with more Medicare Advantage plans to choose from but with renewed criticism that insurers are gaming risk adjustment practices to inflate profits. While ...

SAN FRANCISCO, Oct. 8, 2020 /PRNewswire/ -- Innovaccer, Inc., a leading healthcare technology company, has launched its Risk Adjustment Solution. Leveraging Innovaccer's industry-leading, FHIR-enabled ...

Advanced Analytics, AI, and Automation Become Essential as Payers Face Increased Scrutiny on Risk Adjustment Accuracy and Financial Performance NEW YORK CITY, NY / ACCESS Newswire / June 1, 2025 / As ...