ECLAT Health Solutions, a leading risk adjustment and coding technology partner for Medicare Advantage, Medicaid and ACA plans, announced agentic AI tools and proprietary Confidence Scoring at RISE ...

UPMC Enterprises joins M12 (Microsoft's venture fund) in backing RAAPID's compliance-first Clinical AI Platform for Medicare Advantage risk adjustment ...

UPMC Enterprises has invested in a series A funding round for RAAPID, an AI startup focused on risk adjustment and medical coding that is also backed by Microsoft venture fund M12. RAAPID’s AI ...

A growing range of policy discussions correctly assert that the current Centers for Medicare and Medicaid Services’ (CMS) risk-adjustment system needs modernization, reflecting its long history and ...

The MarketWatch News Department was not involved in the creation of this content. Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with ...

Capturing accurate diagnostic codes through comprehensive risk adjustment programs has become increasingly important for provider-sponsored health plans to improve patient care and clinical quality.

The Biden administration is proposing to increase Medicare Advantage (MA) and Part D plan payments by 1.03% for 2024 amid other changes to the programs’ risk adjustment model. The Centers for Medicare ...

"Healthcare organizations face mounting challenges from risk adjustment coding complexity, impacting both patient care and revenue accuracy. Point of Care Suspects builds on our market-proven, best-in ...

LEWES, Del., April 22, 2025 (GLOBE NEWSWIRE) -- John Snow Labs, the AI for healthcare company, today announced its new end-to-end Hierarchical Condition Category (HCC) coding engine designed to help ...

Introduced with bipartisan sponsorship in March of 2025, the No Unreasonable Payments, Coding, or Diagnoses for the Elderly (No UPCODE) Act intends to address a major problem in Medicare payment ...