Healthcare coding has fundamentally transformed from volume-driven revenue capture to compliance-first, defensible documentation standards.
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 ...
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 ...
RAAPID's AI-powered risk adjustment solution received an A+ would-buy-again grade (Emerging Data, n=5) from interviewed customers in the May 2026 KLAS Emerging Company Spotlight, citing AI accuracy ...
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 ...
Part 1 below covers key tradeoffs and the first two of four categories of strategies that have been advanced to improve risk adjustment in Medicare Advantage. Part 2 tomorrow will cover the remaining ...
The main difference between MedPAC and CMS estimates of uncorrected coding intensity is that MedPAC’s estimate accounts for the upward trend in coding intensity. The growth of the Medicare Advantage ...
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