Risk Adjustment Compliance Recap: Best Practices for Avoiding Legal Action
Last week, Health Fidelity hosted a risk adjustment legal compliance webinar, “Risk Adjustment Compliance: Best Practices for Avoiding Legal Action.” I had the privilege of being joined by Health Fidelity VP of business development John Blevins as well as lawyers and healthcare legal experts Stephen Bittinger and John Lawrence of K&L Gates. The event itself […]
Prioritizing Risk Capture Compliance with NLP
In the past few weeks, several new stories have broken around risk capture compliance issues, particularly when it comes to Medicare Advantage. Individual DOJ lawsuits around MA risk capture and government agencies like the OIG weighing in on MA policy itself have led to a barnstorm of op-eds. The crux of these stories, even the […]
Ten Years of Health Fidelity: Natural Language Processing in Healthcare
Health Fidelity’s NLP engine Lumanent Insights was created based on the NLP engine MedLEE developed at Columbia University by Carol Friedman, PhD. Today, we have two goals. First, to better understand natural language processing in healthcare. Second, to celebrate Health Fidelity’s 10th anniversary and five years of delivering clinical suspects, by helping you get to […]
Leveraging Technology in Data Acquisition to Transform the ROI on Risk Adjustment
Given the importance of patient charts to an organization’s success in risk adjustment, Health Fidelity's data acquisition technology can alleviate the burden of manual retrieval while also improving ROI.
Strategies for Different Patient Populations and Payment Models
One-size doesn't fit all when it comes to the underlying risk adjustment strategies health plans should pursue given the market(s) that they participate in.
Accurate Risk Adjustment Determines Health Plan Performance in ACA Marketplace
Greater emphasis on risk adjustment is needed in the ACA market to support plan viability, accurately establish premium prices, and withstand competitive pressures.