Payment Integrity Program Assessment
Assessing the effectiveness of your payment integrity strategy is crucial for ensuring financial accuracy and operational efficiency within your organization. By taking our assessment, you’ll gain valuable insights into your current payment integrity process for complex claims, such as High Dollar, DRG, and other clinical reviews. Discover areas for improvement and find out how you […]
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Embracing the New Normal: Prospective Risk Adjustment
Embracing the New Normal: Prospective Risk Adjustment The healthcare industry is experiencing a significant transformation, shifting towards value-based care. With the shift to the new risk adjustment V28 model and increased pressure for compliance with the recent RADV ruling, prospective risk adjustment emerges as a pivotal strategy for healthcare providers and payers. This proactive approach […]
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Your prospective risk adjustment team that are reviewers, whether clinical staff or coders on Clinical Documentation Improvement (CDI) teams, plays a critical role in value-based care program success. But this important contribution requires a huge operational undertaking. Ahead of scheduled patient visits, teams are tasked with reviewing large volumes of data spread across multiple health […]
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