Most Healthcare Audit Exposure Doesn't Start ...
Most of what gets called a coding problem is not a coding problem. It is a documentation problem that surfaces in the coding function – months after the clinical encounter, long after the physician has moved on, usually right before an audit.
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July 01, 2026
What TEAM Means for Orthopedic Billin...
The CMS Transforming Episode Accountability Model (TEAM) is in play, and its impact on orthopedic billing services will ...
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June 22, 2026
Prospective, Concurrent, and Retrospe...
Risk adjustment is often discussed as a Medicare Advantage problem. In actuality, it affects every organization whose re...
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June 12, 2026
The New Era of HCC Risk Adjustment: W...
For years, many Medicare Advantage organizations treated HCC risk adjustment as a volume exercise: capture more diagnose...
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June 03, 2026
RiskGen-i & Risk Adjustment in 2026: ...
In 2026, Medicare Advantage risk adjustment is no longer just a coding exercise. It has become a high-stakes operational...
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May 24, 2026
RPM Billing in 2026: A Day in RPM Ser...
Remote Patient Monitoring (RPM) billing sounds like one of those healthcare ideas that should be simple: Patients stay h...
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May 05, 2026
Risk Adjustment & HEDIS in 2026: Why ...
In 2026, health plans, Medicare Advantage organizations, and risk adjustment coding companies across the US face growing...
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October 31, 2025
Risk Adjustment Services Update: 2023...
Risk adjustment audits are changing again, and leaders in charge of risk adjustment services should take note as the imp...
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October 27, 2025
Accuracy Isn't Enough in Risk Adjustm...
Accuracy gets all the attention in risk adjustment coding, and rightly so. It’s the backbone of compliance, reimbursemen...
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June 30, 2025
The Vital Role of Risk Adjustment Med...
In today’s value-based healthcare environment, risk adjustment medical coders are essential to the financial health, reg...
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