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The Opportunities of Technology-Enabled Risk-Sharing
Over 10% of the U.S. population is now covered by an accountable care organization (ACO), and the number of risk-adjusted lives is growing at roughly 15% to 20% each year. To date, risk adjustment has primarily consisted of payers retrospectively reconciling work done with payments owed. With the Medicare Access and CHIP Reauthorization Act (MACRA) […]
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Concurrent Coding Increases Claims Accuracy While Reflecting True Patient Disease Burden
Concurrent coding is an alternative audit process to correct documentation and coding errors that immediately follows the physician visit, before a claim is submitted for payment. Physicians are not coders, so concurrent coding finds billing oversights that physicians might overlook in the rush to complete electronic paperwork. Automating concurrent coding is available with the Lumanent Post-Encounter Review module from Health Fidelity.
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Value-Based Care is Here to Stay: Key Strategies for Developing a Risk Adjustment Program
Our comprehensive, encounter-centric framework helps providers develop an effective risk capture program to achieve success in value-based care.
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3 Takeaways to Look for at RISE West
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.
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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?
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How Technology Can Help Ensure the Utmost Compliance in Your Risk Adjustment
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.
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Clinical Data Acquisition with Technology
Vast amounts of clinical data are generated daily, but traditional methods of collecting and making use of it are inadequate. Adam Gronsky explores options for risk-bearing entities to invest in technology-enabled solutions that require minimal maintenance and decrease the need for manual retrieval in this month's post.
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360-Degree Risk Adjustment: A Strategic Lever for Risk-Bearing Entities
Steve Whitehurst presents three reasons why the 360-Degree Risk Adjustment strategic framework for optimizing coding performance needs to be part of any risk-bearing organization's 2017 plans.
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360-Degree Risk Adjustment: Our Framework for Optimization
Introducing 360-Degree Risk Adjustment - a strategic approach that considers risk adjustment optimization from all angles, including technology modernization, enhanced provider collaboration, departmental integration, and performance management.
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Are You Overestimating Risk Scores?
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.
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Decreasing Inherent Waste in Coding Operations
With risk adjustment becoming increasingly important to the bottom line of health plans and the wellness of patients, Christina Sung offers strategies for organizations to adopt new coder technology with low time-to-value barriers.
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Aligning Risk Adjustment and Quality Management to Impact Profitability and Compliance
Risk Adjustment and Quality typically operate in distinct silos, despite the fact that they are both working to achieve goals that are closely related. Our CEO calls for collaboration between these different but closely aligned components.