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Second-Level Review (2LR) Strategies to Mitigate Risk on Final Submission to CMS
November 5, 2021The Centers for Medicare and Medicaid Services (CMS) has focused on Risk Adjustment data submissions for many years with Risk Adjustment Data Validation (RADV) audits. The Office
Read More »Leveraging Technology to Optimize Quality Assurance Strategies
September 8, 2021Have you ever thought about the effectiveness of your quality assurance program? Do you use technology to execute best practices? The industry standards identify accuracy requirements by the Centers f
Read More »Talix’s Takeaways on the Recent MA Payment Year 2022 Announcement
February 24, 2021In light of various challenges that payers and providers are facing due to the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) issued 2022 Medicare Advantage and Part
Read More »Telehealth Security and Workflow Optimization
September 10, 2020As the final blog post in our telehealth series, we will highlight security and workflow considerations for providers to enhance their telehealth platform and integrate it better into existing workflo
Read More »How to Avoid Telehealth Documentation Pitfalls
August 3, 2020The year 2020 brought us the novel coronavirus. In response, our friends at the Centers for Medicare & Medicaid Services (CMS) stepped up to encourage healthcare providers to adopt tel
Read More »Telemedicine – Healthcare’s New Differentiator
July 24, 2020We have seen an exponential growth in the number of telemedicine visits being performed since the pandemic’s arrival on our shores. While this growth is expected to plateau, telemedicine is
Read More »The Ensuing Challenges of Telemedicine and Reimbursement
July 15, 2020Telemedicine has exploded out of necessity to address healthcare needs amidst stay in place constraints, but it’s created new reimbursement changes especially for the value-based care market.&
Read More »The Coronavirus Pandemic introduces three unforeseen challenges to Health Plan Risk Adjustment Operations
July 14, 2020The Coronavirus Pandemic introduces three unforeseen challenges to Health Plan Risk Adjustment Operations. The American healthcare industry will undergo significant disruptions as the coronavirus cris
Read More »5 Tips for Selecting Your Second-Level Chart Review (2LR) Vendor Infographic
July 9, 2020Second-Level Review with NLP-Enabled Technology Will Boost Coding Accuracy Machine learning technology and advanced natural language processing can detect and extract HCC codes that were missed or mis
Read More »Finally, Machine-Learning in Health Care
May 19, 2020Some tech buzzwords stir up excitement in some people but mostly trepidation.Artificial intelligence (AI) and machine learning (ML) are two of those terms. Those who understand the benefits of AI
Read More »How Intelligent Analytics Increase Quality and Lower the Costs of Risk Adjustment Programs
April 19, 2020Medical coding is the backbone of risk adjustment. Coding needs to be efficient and accurate to keep up with the increasing influx of sensitive patient data, and CMS regulations. Budgeting
Read More »Optimize Data with Patient Data Analytics in Medical Coding
March 19, 2020Technology has allowed for new and innovative ways to capture a more conclusive look at member health data. Data can be powerful when handled properly; however, many healthcare organizatio
Read More »3 Tips to Thwart Healthcare System Hackers
February 3, 2020Over the past few years, healthcare IT systems have faced significantly more cyberattacks than any other industry—and the reasons why are pretty simple: The reality is that these security breaches
Read More »4 Critical Advantages to Deciphering Data with NLP
January 3, 2020By now, most health plan providers are aware that an efficient risk adjustment program is the key to maximizing reimbursements and improving patient care. But what’s the best way to
Read More »2019 – Year In Review
December 28, 2019As this year comes to a close, it’s time to take a look back at my predictions for 2019 and see just how right (or wrong) I was. Last year,
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