Hospitals and provider groups across the country were the first to feel the effects of COVID-19 as they scrambled to adapt to or dramatically increase telehealth visits as stay in place measures took effect. Managing patients remotely through virtual settings at scale became critical. Two major questions bubbled up as providers switched over to this new medium.
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The American healthcare industry will undergo significant disruptions as the coronavirus crisis penetrates the American landscape. Three critical events are already affecting the Risk Adjustment operations process at America’s health plans for 2020.
Second-Level Review with NLP-Enabled Technology Will Boost Coding Accuracy Machine learning technology and advanced natural language processing can detect and extract HCC codes that were missed or miscoded during first-level reviews. Missed codes identified on a second-level review can result in millions of dollars in additional reimbursement for health plans while also improving RAF score accuracy.
Learn how artificial intelligence and machine learning can increase efficiencies in the health care industry, including for Risk Adjustment programs.
Medical coding is the backbone of risk adjustment. Coding needs to be efficient and accurate to keep up with the increasing influx of sensitive patient data, and CMS regulations.