Healthcare Finance News February 5, 2023
The RADV final rule comes after increasingly high profile instances of apparent over coding from Medicare Advantage Organizations.
The best way for insurers to make sure they’re in compliance with the mandates of risk adjustment is to use natural language processing for accurate documentation and auditing, according to Dr. Calum Yacoubian, director, Healthcare Strategy, Linguamatics, an IQVIA company that offers an NLP-based AI platform.
Last week’s publication of the final rule for risk adjustment data validation (RADV) comes after increasingly high profile instances of apparent over coding from Medicare Advantage Organizations, Yacoubian said.
There must be an audit trail, he said.
NLP identifies gaps in care from unstructured notes in the clinical record. It enables the creation of a longitudinal...
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