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As the new year unfolds, healthcare professionals are not only setting personal resolutions but also strategizing for success in their respective fields. Among the critical considerations for 2024 is risk

As the healthcare landscape continues to evolve, it is imperative for Medicare Advantage Organizations (MAOs) and stakeholders to continuously assess opportunities for innovation and improvement within the Medicare Advantage risk

Recap of healthcare transformations in 2023 In 2023, the healthcare industry witnessed significant transformations that set the stage for the trends we can expect in 2024. One of the most

Introduction: In a recent audit conducted by the Office of Inspector General (OIG), SelectCare of Texas, Inc. (SelectCare), a Medicare Advantage (MA) organization, faced scrutiny for submitting diagnosis codes to

In the intricate tapestry of healthcare, social determinants often weave their way into the fabric of well-being. From financial instability to food insecurity, these challenges significantly impact the health of

Introduction to Emedlogix NLP and HCC Risk Adjustment Coding In the ever-evolving field of healthcare, accurate and efficient coding plays a crucial role in ensuring proper reimbursement, compliance, and overall

In UShealthcare, organizations are continually seeking innovative ways to optimize their revenue streams and provide high-quality patient care. One critical aspect of this pursuit is efficient risk adjustment coding, a

Unlocking the full potential of healthcare begins with population health management. In an era where preventive care and proactive strategies are gaining prominence, it is essential to shift our focus

Introduction to Prospective Payment System (PPS) In today’s ever-evolving healthcare landscape, it is crucial for providers and patients alike to understand the intricacies of reimbursement methodologies. One such methodology that