Artificial intelligence (AI)-enabled tools such as natural language processing (NLP) have been integrated into a wide range of applications, including risk adjustment coding tools, for greater ...

There is widespread agreement that taxpayers pay more when Medicare beneficiaries are enrolled in Medicare Advantage (MA) plans than if those beneficiaries were enrolled in traditional Medicare. MA ...

CMS and policy makers could pursue simple, incremental reforms to reduce overpayment in Medicare Advantage while also paving the way for longer-term solutions to reduce incentives to upcode. To ...

LOUISVILLE, Ky., Feb. 28, 2025 /PRNewswire/ -- RAAPID, an AI-powered risk adjustment technology leader, will present critical insights on modernizing RADV audit preparation, sharing real-world results ...

Review Proposed Changes for Medicare Advantage Plans in 2024 Discuss the change from Version 24 to Version 28 and the impact on Risk Adjustment Calculation Methodology Explain how Fee-for-Service will ...

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 ...

Proprietary Confidence Score and agentic tools improve performance and value for risk-bearing payers ECLAT Health Solutions, a leading risk adjustment and coding technology partner for Medicare ...

Jan 12 (Reuters) - Health insurer UnitedHealth Group (UNH.N), opens new tab used aggressive risk-adjustment coding tactics to increase U.S. government reimbursement for patients enrolled in its ...

The Biden administration finalized a proposal to raise Medicare Advantage payments by 3.32% in 2024, slightly above the 1% raise that it proposed. The final payment rule released Friday comes after an ...