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- Category: Affordable Care Act
- Category: Artificial Intelligence
- Quality Assurance of Outsourced Medical Record Reviews
- How Analytics Can Help with Chart Chasing
- AI in the Federal Government: RaLytics™ Technology Platform and Policy-Driven AI Tools are Designed to Help Pave the Way Forward
- Artificial Intelligence Can Improve Risk Adjustment Data Validation for Managed Care Plans Serving Duals
- How Real AI Can Revolutionize Risk Adjustment
- Category: Interoperability
- Category: Policy
- HCC Failure Rate Groups and the Supplemental Diagnosis File
- Accurate Medical Coding, Part 2: Understanding Sources of Variation in Medical Coding
- Accurate Medical Coding, Part 1: The Role of Medical Coding in Healthcare Payments
- The Importance of Supplemental Diagnosis Code Submissions for ACA Risk Adjustment
- Section 508: Are You Compliant?
- Improper Payments in Federal Healthcare Programs
- OIG Audits
- Risk Adjustment in ACA Marketplaces: The 2023 Final Rule
- Risk Adjustment in ACA Marketplaces: What to Watch Out For in Benefit Years 2023 and Beyond
- The Medicare Advantage Payment Cycle: Opportunities & Obligations
- Including Social Determinants of Health factors in the Medicare Advantage Risk Adjustment Program
- MA Risk Adjustment to Complete Shift to Encounter Data in 2022
- The 21st Century Cures Act Impact on Medicare Advantage Risk Adjustment: Part IV – Using Multiple Years of Diagnosis Data
- Recent Court Ruling Reinstates the Overpayment Rule
- The 21st Century Cures Act Impact on Medicare Advantage Risk Adjustment: Part III – Adjustments for Dual Enrollees
- The 21st Century Cures Act Impact on Medicare Advantage Risk Adjustment: Part II – Adjusting for Additional Conditions
- The 21st Century Cures Act Impact on Medicare Advantage Risk Adjustment: Part I – Adjusting for the Number of Conditions Each Enrollee Has
- Risk Adjustment Validation Under Medicare Advantage: Part II
- Risk Adjustment Validation Under Medicare Advantage: Part I
- Category: Regulatory Reviews
- Category: Risk Adjustment
- Proposed Changes to MA RADV Appeals Process
- Medical Coding – The Importance of Following Authoritative Guidelines and References
- Accurate Medical Coding, Part 3: Evaluating Medical Coding Reliability with IRR
- RADV Final Rule
- The 2018 MA RADV Proposed Rule
- Payment Inaccuracy in the Medicare Advantage Program: Underpayment Due to Underreported Diagnoses
- Potential COVID-19 Impacts on Medicare Managed Care Risk Adjustment