In late 2024, the Centers for Medicare and Medicaid Services previewed a significant revision to the risk-adjustment model ...

The Medicare Advantage (MA) risk-adjustment system increases and decreases MA plan payments based on the health risks of their enrollees. The current system assesses health risk based on Hierarchical ...

Compliance Auditor Provides Health Insurers Much-needed Insight into Risk Adjustment Coding, Ensuring Accurate Payments and Reducing Audit Risk San Mateo, Calif. – July 6, 2017 – Apixio Inc., the data ...

Medicare open enrollment kicked off Friday with more Medicare Advantage plans to choose from but with renewed criticism that insurers are gaming risk adjustment practices to inflate profits. While ...

A federal lawsuit claims that UnitedHealth Group, the largest Medicare Advantage insurer in the country, is coding medical claims inappropriately for monetary gain. But while the lawsuit doesn't ...

A federal lawsuit has focused attention on how the industry uses medical codes for risk adjustment. While the lawsuit doesn’t involve physician practices, it’s a heads-up for them to pay attention to ...

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., May 16, 2022 (GLOBE NEWSWIRE) -- The RAAPID risk capture platform is actively taking medical coding to the desired leap of accuracy and profitability with its unique usage of ...

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’ ...

Healthcare risk management solutions company Talix has launched Coding InSight for Payers. Coding InSight for Payers is designed to help health plans automate and streamline risk adjustment processes ...

LEWES, Del., April 22, 2025 (GLOBE NEWSWIRE) -- John Snow Labs, the AI for healthcare company, today announced its new end-to-end Hierarchical Condition Category (HCC) coding engine designed to help ...