Revisiting Payer Contract Review for Success in 2024
Healthcare providers should constantly be reviewing and assessing the performance of their payer contracts. But as the payer contract management environment continues to shift.
Why Medicare Advantage Plans And ACOs Need Experienced Vendors To Prepare For CMS-HCC Version 28
Medicare Advantage (MA) plans and Accountable Care Organizations (ACOs) should be reevaluating their vendor strategy in light of coming changes. This is largely because of a new version of the Hierarchical Condition Category (CMS-HCC) risk adjustment model that CMS released in 2023.
8 Signs You Should Invest In A Medical Coding Audit Before 2024
All the change in healthcare over the recent years has unfortunately meant new opportunities for abuses of medical billing. This kind of fraud and misuse puts providers at risk financially and ultimately jeopardizes the quality of care you can provide in the long term. Many providers who have realized this understand that now is a good…
Why Self Audits Are One of the Most Valuable Medical Coding Audits
Medical coding audits are critical to a healthy revenue cycle, but with all the options, it is difficult to know where to position the different types of medical coding audit services in your revenue cycle management optimization strategy.
Risk Adjustment Reviews Are Your Key To Success In Value Based Contracts
Retrospective reviews of risk adjustment coding are foundational to the financial health and stability of Accountable Care Organizations (ACOs) and Medicare Advantage plans (MAPs). This is increasingly true as value-based contracts.