AI models outperform traditional rule-based systems in identifying high-risk patients by integrating diverse data sources and ...
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 ...
Martlet.ai, a healthcare AI company spun out of John Snow Labs, today announced the launch of its Risk Adjustment Data ...
For 2022, the Centers for Medicare and Medicaid Services is proposing to use only encounter data in calculating risk adjustment used to pay Medicare Advantage plans. The Part C risk score would rely ...
On March 31, 2023, CMS finalized its Announcement of Methodological Changes for Calendar Year (CY) 2024 for Medicare Advantage (MA) Capitation Rates. One of the most significant changes for 2024 is ...
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 ...
SAN FRANCISCO, CA / ACCESS Newswire / September 24, 2025 / Ambience Healthcare today announced the launch of its HCC Compliance Validator. Already live with eight healthcare organizations, the HCC ...
On March 25, 2025, U.S. Senators Bill Cassidy, M.S. (R-LA) and Jeff Merkley (D-OR) introduced the No Unreasonable Payments, Coding, or Diagnoses for the Elderly (No UPCODE) Act (the “Bill”). According ...
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