• Recently, we discussed the imperative of HCC recapture, especially in a year with encounter volumes heavily disrupted by COVID-19. However, HCC recapture is only a small part of the larger goal: discerning a complete and accurate risk profile of a covered population. With an accurate risk score, reimbursement can match the total cost of necessary […]

  • An effective and essential risk adjustment strategy includes the prioritization of chronic condition recapture each year. The benefit of prioritizing your HCC recapture rate comes directly from the requirement of re-confirming a diagnosis and treating it. First, it ensures regular contact with clinicians to monitor and manage chronic conditions, overall improving the quality of care. […]

  • An in-depth look at how our technology stack processes information from our NLP engine, Lumanent Insights, to derive clinical suspects and deliver them to providers.

  • Natural language processing (NLP) has become a buzzword in healthcare. Organizations across the industry have moved into the space, and, for the most part, we support these moves. As an organization, we believe in the value of using artificial intelligence to support human experts in boosting the administrative stability and quality of care. Healthcare is, […]

  • Here are the top 4 healthcare trends we see for 2018. Find out how the CVS and Aetna merger will impact the way healthcare entities operate moving forward, and why AI and machine learning will continue to be a hot topic.

  • If compliance is a key priority for your organization, we’ve put together a brief “playbook” of the areas we recommend you explore during your 2017 RISE West Summit trip.

  • Big data. Artificial intelligence. Cognitive computing. Natural language processing. Machine learning. These terms have become the latest buzzwords in healthcare. But what do they mean?

  • Teresa Ross discusses the buzz around compliance in risk adjustment. Find out how technology-enabled solutions can help achieve the utmost compliance in an efficient and effective manner.

  • Christina Sung sits down with Dr. Rob Kalfus, Health Fidelity’s Clinical Informaticist, to address some commonly asked questions about Natural Language Processing. Rob delves into the application of NLP technology in risk adjustment and explains how Health Fidelity's technology is uniquely suited to healthcare.

  • Overlooking missed diagnoses is just half of the challenge of attaining accurate risk scores. Learn how solve the other half by applying technology to help with compliance in this post from Health Fidelity Director of Coding & Quality, Kathy Ormsby.

  • Health plans face multiple issues that can lead to an inaccurate portrayal of patient acuity and unidentified risk. With an eye toward incremental progress, here are a few strategies for risk identification improvement.

  • With the right technology, the analytical value and insights gained from incorporating clinical data into risk adjustment operations is worth the effort.