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reflections from a healthcare IT “up-and-comer”

Wednesday, Becker’s Hospital Review recognized Verscend’s Jordan Bazinsky, executive vice president of product and strat...

busted: rounding up the top fraud schemes of Q2 2018

The nation’s top special investigators and law enforcement officials were hard at work stamping out the weeds of healthc...

breaking it down: CMS reinstates ACA risk adjustment payments

On Tuesday, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that enables the federal government t...

podcast: how risk adjustment coding validation gives health plans more certainty

Compliance is becoming an increasingly difficult challenge for Medicare Advantage plans, especially when it comes to the...

crunching the numbers as ACA risk adjustment transfer payments are put on hold

On Monday, the Centers for Medicare & Medicaid Services (CMS) released the health plan-specific 2017 benefit year risk a...

podcast: navigating to better Star Ratings performance

You’ve submitted your final data to NCQA and CMS, marking the end of the HEDIS® 2018 marathon. Now it’s on to the next c...

avoid the latest rash of asthma and allergy schemes in provider billing

While the cause of the rise in asthma and allergy rates over the past several years isn’t 100 percent clear, one of the ...

video: suspecting analytics transformed—the rapid movement from clinical rules to machine ...

In the complex world of risk adjustment, health plans rely on suspect analytics to identify members with possibly undocu...

podcast: the final sprint to the HEDIS 2018 finish

The countdown is on for the June 15 deadline to submit your HEDIS 2018® data, and there’s no shortage of details to keep...

podcast: validating clinical claims without medical record review

Automated claim editing systems are a crucial component of accurate and efficient claims payment. But there will always ...

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