Proprietary Confidence Score and agentic tools improve performance and value for risk-bearing payers HERNDON, Va.--(BUSINESS WIRE)--ECLAT Health Solutions, a leading risk adjustment and coding ...

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

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 ...

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 ...

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 ...

A federal lawsuit has focused attention on how the industry uses medical codes for risk adjustment. While the lawsuit doesn’t involve physician practices, it’s a heads-up for them to pay attention to ...

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’ ...

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 ...

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 ...

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 ...

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 ...

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 ...