'Interesting Reads' on Health care Risk adjustment solution, Audit & more
Clinical Documentation Improvement (CDI) plays a critical role in ensuring accurate patient records, appropriate reimbursement, and …
Introduction ACO Key Challenges Faced by CMOs Submission Timeline Planning RAAPID Risk Adjustment Solutions: Helping ACOs …
As healthcare moves toward value-based models, primary care providers (PCPs) and health plans face increasing pressure …
In the intricate world of value-based care, where precision and accuracy can make all the difference, …
As CMS finalizes the 2026 payment policy updates for Medicare Advantage and Part D programs, the …
The Centers for Medicare & Medicaid Services (CMS) has laid the groundwork for a transformative shift …
Introduction Understanding the 2023 CMS Final RADV Rule CMS’s First RADV Audit Notices for PY2018 The …
As the healthcare landscape evolves, the transition to the CMS-HCC (Hierarchical Condition Category) Model V28 represents …
Understanding Modern Risk Adjustment Needs What is Risk Adjustment? Leading Risk Adjustment Technology Companies Technology Innovation …
Risk adjustment software is no longer just an optional tool; it is a necessity for healthcare …
The healthcare industry continues to evolve, with risk adjustment coding playing an increasingly central role in …
Concurrent vs Retrospective Coding: Real-Time Advantage in Risk Capture Real-Time Risk Adjustment: Measured Impact on Documentation …
Risk adjustment services have transformed from simple coding solutions into comprehensive programs impacting every healthcare delivery …
A Shared Vision for People Excellence At RAAPID Inc., our greatest strength lies in our people. …
Introduction Importance of ‘Annual Wellness Visits’ for Providers Hidden Challenges in Traditional Annual Wellness Visits Annual …
Background Maneuvering Through the Nuances of ACA Risk Adjustment ACA Deadlines 2025 And How They Affect …
Introduction The Importance of Year-End Preparation Why a Comprehensive Year-End Audit Holds Key Relevance Adopting AI-driven …
Introduction AI-Empowered Foresight For Comprehensive Patient Health Understanding NLP Emerges As The Pivotal Remedy AI-Powered Prospective …
The transition to ICD-10 has been a monumental leap in healthcare, expanding from 14,000 to over …
Coder Dilemma: A Techno-Philosophical Reflection Myth #1: NLP Replaces the Need for Human Coders, Leading to …
Risk Adjustment Continuum Is Premised On Payer-Provider Collaboration Understanding The Risk Adjustment Continuum In Changing Times …
Evolution of Forward-Thinking Health Plans The evolution of forward-thinking health plans serves as a profound reminder …
RISE West 2024: Expanding the Horizons of Healthcare & Risk Adjustment We are thrilled to participate …
The arrival of new regulations such as the RADV Final Rule and the 2023 Final Rate …
Table of Content: HCC Primer Workability of HCCs Importance of HCC Coding underlying the risk adjustment …
As value-based care providers and organizations aim to ensure accurate risk adjustment for Medicare reimbursement, understanding …
Ever wonder how healthcare plans balance their premiums despite enrolling individuals with varying health risks? Enter …
Balancing financial sustainability and high-quality patient care in value based healthcare is challenging, especially with disparities …
Healthcare Plans are in constant flux, making it vital for Medicare Advantage Organizations (MAOs) and medical …
Are you ready for major changes impacting your healthcare costs in 2025? Even though it’s several …
In the ever-evolving Medicare Advantage risk adjustment landscape, understanding the shifts and developments is crucial for …
How CMS Star Ratings are assessed The Centers for Medicare & Medicaid Services releases its quality …
Retrospective Audit and its importance for MA organization Ensure quality care is being provided to Medicare …
In humble appreciation, we acknowledge that attending conferences transcends mere networking and product showcases. It’s a …
Introduction Why Neuro-Symbolic AI Neuro-symbolic AI strives to blend the strengths of both domains Neuro Symbolic …
Rising To The Occasion Amidst a Collaborative Spirit RAAPID’s Cutting-Edge Solutions Unveiled At RISE National 2024 …
Between 2024 and 2025, payments to Medicare Advantage plans are anticipated to increase by an average …
Introduction The Hierarchical Condition Category (HCC) risk adjustment model, initially introduced by CMS in 2004, serves …
CMS UNVEILS THE PROPOSED FINAL RULE FOR MEDICARE ADVANTAGE IMPACTING HEALTH PLANS, PROVIDERS & PATIENTS. The …
Healthcare providers today face the challenge of effectively managing chronic diseases, a task made more complex …
The release of the 2024 Medicare Advantage Star Ratings marks a critical juncture for health plans …
Table of Content: Understanding the Revisions in HCC Codes The Impact on RAF Scores RAAPID’s Approach …
The Centers for Medicare & Medicaid Services (CMS) recently unveiled a comprehensive CMS proposed rule for …
Introduction In value-based care, Hierarchical Condition Category (HCC) and Risk Adjustment Factor (RAF) scores are more …
The Medicare Risk Adjustment landscape is a complex one, with health plans constantly striving to ensure …
Introduction Implementing a prospective risk adjustment solution in ACOs presents multifaceted challenges. Daily, there’s the arduous …
In the complex healthcare landscape, where regulatory oversight is rigorous and financial risks loom large, health …
Data interoperability has emerged as a pivotal force in healthcare, especially in the context of prospective …
In the ever-evolving landscape of healthcare, health Plans are constantly seeking efficient and reliable solutions to …
Healthcare providers, including physicians, nurses, and administrative staff, are the backbone of the healthcare industry. Their …
Nestled in the southwest, just a stone’s throw from Dallas Fort Worth international airport, the Omni …
Embarking on a Quest for Precision In the sprawling realm of healthcare coding, precision isn’t just …
Physicians are the unsung heroes of healthcare, dedicating their lives to saving others. However, the relentless …
The field of medical coding plays a crucial role in healthcare, ensuring accurate and standardized documentation …
Are you tired of spending countless hours in order to ensure efficient coding for Centers for …
The business of healthcare delivery requires a combination of learned, attentive patient care and thorough documentation …
As the healthcare industry continues to evolve and become more complex, health plans are constantly seeking …
As healthcare professionals, we know that accurate documentation is essential for quality patient care, billing, and …
Are you tired of sifting through mountains of coding reviews, only to find the same mistakes …
As a healthcare professional, you understand the importance of accurate coding and documentation, especially when it …
Welcome to our latest blog post about a crucial element of healthcare billing: Hierarchical Condition Category …
If you’re still struggling to get a handle on risk adjustment documentation and coding, don’t worry-you’re …
To remain solvent and profitable, healthcare payers must constantly seek new ways to optimize their operations, …
Are you tired of the complexity and confusion that comes with hierarchical condition category (HCC) coding? …
With many healthcare organizations transitioning to value-based care (VBC) programs, ensuring accurate hierarchical condition category (HCC) …
With the recent Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) Final rule update shared by …
In the release of the Medicare Advantage Risk Adjustment Data Validation Final Rule by the US …
Are you preparing for the upcoming 2023 Mid-Year risk adjustment data submission? Are you worried about …
Hierarchical condition category (HCC) coding is a risk-adjustment model which is designed to estimate future healthcare …
Risk Adjustment is a statistical process that considers the underlying health status and health spending of …
Healthcare fraud and misuse is a federal offense and negatively impacts care delivery on the whole. …
Medical coders play an important role in the revenue cycle management for the healthcare ecosystem, however, …
An AI-Based Risk Adjustment Coding solution does more than simply identify bad claims to fix them, …
There are 3,834 Medicare Advantage Programs¹ as of 2022, and the total Medicare Advantage enrollees have …
The global natural language processing (NLP) market revenue is expected to reach 43 billion in 2025.¹ …
Hierarchical Condition Categories (HCCs) and ICD-10-CM codes risk adjustment solution is becoming a trending topic amongst …
With the modern technology inclusion in the health care ecosystem, payers will have to be coerced …
A survey conducted to understand the healthcare payer market size, shares, trends, and analysis stated that …
One of the most common barriers to conducting patient chart reviews for the health care payer …
A Study by the National Library of Medicine¹ has stated that several types of Artificial Intelligence (AI) …
In a recent study by MarketsandMarkets conducted to understand the advantages of artificial intelligence (AI) in …
