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 ...

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 ...

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 ...

Claims data, which form the foundation of risk adjustment in payment for health care services, may reflect efforts to capture more—or more severe—clinical conditions rather than true changes in health ...

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’ ...

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

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 ...

As Medicare payment models evolve, reconciling differences in coding intensity between Medicare Advantage (MA) and traditional Medicare (TM) is a persistent challenge. High coding intensity in MA 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 ...

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 ...

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 ...

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 ...