The research from the Alliance for Community Health Plans adds to existing evidence that major insurers are unfairly ...

With all the changes to risk adjustment coding specifically, such as constrained coefficients for some hierarchical condition categories, individual coders will need additional education that ...

The Alliance of Community Health Plans (ACHP) is making the case that risk adjustment in Medicare Advantage (MA) needs a ...

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 ...

To partially correct for overpayments due to coding, the Centers for Medicare and Medicaid Services (CMS) applies a coding intensity adjustment of 5.9 percent to MA risk scores.

By limiting extreme profits (severe overpredictions), too, a two-sided approach further improves the fit of a risk-adjustment model and helps to discourage cream-skimming and aggressive coding.

For risk adjustment, Cavo offers a next-generation coding solution purpose-built to support Medicare Advantage, Medicaid, and Commercial risk programs.

For risk adjustment, Cavo offers a next-generation coding solution purpose-built to support Medicare Advantage, Medicaid, and Commercial risk programs.