Healthcare coding has fundamentally transformed from volume-driven revenue capture to compliance-first, defensible documentation standards.

Objective To investigate the association between attention-deficit/hyperactivity disorder (ADHD) and cardiometabolic risk profile at the time of type 2 diabetes (T2D) diagnosis and examine ...

As the Medicare Advantage market continues to evolve amid regulatory change, margin pressure, and ongoing member movement, it remains a crucial growth and performance priority for many health plans.

The Office of the Inspector General (OIG) continues to focus on Medicare Advantage (MA) risk adjustment payments, issuing a report this week detailing its audit of MA risk adjustment payments based on ...

A Ki-67/CD34 prognostic model for risk stratification in resected gastrointestinal stromal tumors. This is an ASCO Meeting Abstract from the 2026 ASCO Annual Meeting I. This abstract does not include ...

Healthworx, the investment arm of CareFirst, Inc., invests in RAAPID, signaling a massive market shift toward "Audit-First" AI as CMS intensifies scrutiny on Medicare Advantage. LOUISVILLE, ...

RAAPID, Inc., the leader in AI-powered risk adjustment solutions, today announced a strategic investment from Healthworx, the investment arm of CareFirst, Inc. This milestone completes an ...

Objectives Adequate risk adjustment for factors beyond the control of the healthcare system contributes to the process of transparent and equitable benchmarking of trauma outcomes. Current risk ...

Correspondence to Dr Anita Koushik, Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada; anita.koushik{at}umontreal.ca Objectives To investigate ...

Go to the full version which has been optimized for online reading. La version française de ce guide est intitulée Guide de l’employeur – Comment produire le feuillet T4 et le Sommaire. The Canada ...

The CMS has provided a long-awaited update on how it plans to approach Medicare Advantage audits, five months after a federal judge threw a wrench in the agency’s plan to drastically expand the money ...