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how to navigate RAPS-to-EDS revenue expectations

In the 2017 payment year, the 25 percent Encounter Data System (EDS) contribution and its impact on risk scores and asso...

trick or treat: solving the spooky RAPS/EDS transition challenge

Visiting a corn maze on Halloween can be fun, but trying to navigate the transition from RAPS to EDS has been more like ...

improve medical record retrieval success by analyzing provider behavior patterns

Medical record retrieval is labor intensive, consumes time and resources, and requires great patience and persistence—bu...

infographic: analyzing 2017’s risk adjustment valuation to improve 2018’s processes

How is your health plan setting its target return on investment (ROI) per chart for your 2018 retrospective risk adjustm...

amid healthcare reform, ACA risk stabilization goes on

While the House and Senate attempt to re-write healthcare policy, the pressing problems that the Affordable Care Act (AC...

step up your game: how to improve risk adjustment coding accuracy

The Office of Inspector General (OIG) sets the bar for coding accuracy at 95 percent, but you can’t achieve that goal wi...

the 2018 final payment notice: the top four takeaways

After listening to public comments, the Centers for Medicare & Medicaid Services (CMS) has released its Final Notice for...

RISE to the occasion: quality, risk adjustment, payers, and providers converge

Although its Nashville location remains the same, the Annual RISE Summit continues to grow in size and importance each y...

the art and science of handling Medicare risk adjustment coding “gray areas”

While the Centers for Medicare & Medicaid Services (CMS) has guidelines in place for Medicare risk adjustment coding, th...

the 2018 advance payment notice: what you need to know

Health plan executives across the country have a lot of planning to do now that the 2018 Advance Payment Notice for Medi...

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