Inpatient encounters for Medicare patients 65 years and older are associated with higher coding intensity compared with commercially insured, Medicaid, or self-pay hospitalizations for those same ...
Ambience Healthcare rolled out an ICD-10 clinical document integrity assistant for inpatient care, aiming to help hospitalists document more accurate clinical notes and reduce billing and coding ...
New York, United States — May 8, 2026 — RAAPID INC launched a unified Risk Adjustment Platform designed to integrate clinical documentation, coding, quality assurance, audit management, and evidence ...
The clash between payers and providers over AI-driven coding is intensifying, with insurers arguing that documentation tools are inflating reimbursement without corresponding care. AI is quickly ...
Under the current Medicare Advantage (MA) risk-adjustment system, plans are incentivized to report diagnosis codes on enrollees’ medical claims reflecting additional and more severe health conditions ...
Some limits on how the assessments are used for adding new diagnosis codes might be justified to ensure Medicare Advantage plans aren’t overpaid, researchers wrote. Under MA, insurers contract with ...
As we reported in our Managed Care Newsletter in April 2020, the CARES Act passed by Congress last year provides for a 20% increase to the DRG weights in the Medicare Inpatient Prospective Payment ...
The Centers for Medicare & Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) have released the updated ICD-10-CM Official Guidelines for Coding and Reporting for fiscal year ...
Inpatient hospital stays have become more expensive to the Medicare program. It's a trend that began even before the COVID-19 pandemic. A new report from the Department of Health and Human Services' ...
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