By Wynda Clayton,Director of Risk Adjustment Coding & Compliance, RAAPID INC | Autonomous coding seemed too risky. But with regulatory uncertainty ahead, MA Plans need technology they can defend. Here ...

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 ...

Vatica Health (“Vatica”), a Frazier Healthcare portfolio company and leader in provider-centric, prospective risk adjustment and clinical quality solutions, is pleased to announce the closing of its ...

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’ ...

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 ...

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 ...

George Witwer, CEO of Cavo Health Outperforms Machine Learning Tools with 96%+ HCC completeness, 2–4x Productivity Gains and Reduced Audit Risk Our platform delivers more accurate, audit-ready results ...

Capturing accurate diagnostic codes through comprehensive risk adjustment programs has become increasingly important for provider-sponsored health plans to improve patient care and clinical quality.

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 ...

BELLEVUE, Wash.--(BUSINESS WIRE)--Edifecs, Inc., a global health information technology solutions company, today announced Point of Care Suspects, expanding its comprehensive Risk Adjustment offering ...

New data analysis shows stark variation in risk adjustment from abusive industry practices WASHINGTON, Sept. 3, 2025 /PRNewswire/ -- New analysis by the Alliance of Community Health Plans (ACHP) shows ...