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 ...
Alicia Scott, CPC, CPC-I, CRC, boasts over four decades of immersive experience in Healthcare Information Management (HIM). She embarked on her professional journey as a Medical Records Clerk, ...
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 ...
The Biden administration is proposing to increase Medicare Advantage (MA) and Part D plan payments by 1.03% for 2024 amid other changes to the programs’ risk adjustment model. The Centers for Medicare ...
The growth of the Medicare Advantage (MA) program to over half of eligible Medicare beneficiaries has made MA payment a salient part of Medicare policy discussions. Those discussions often focus on ...
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 ...
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 ...
In fact, a September 2021 report from HHS’ Office of Inspector General highlighted potential concern around Medicare Advantage plan risk adjustment practices. The report found that 20 plans received ...
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