Jay Anders, MD, CMO of Medicomp Systems writes for Medical Economics on AHIP’s recent press release and their stance on the new CMS final rule regarding Risk Adjustment Data Validation for Medicare Advantage (MA) plans. Read the full article here.
Clinical Lens
Today’s healthcare problem isn’t a lack of data; it’s a lack of usable data. Clinical Lens identifies and interprets disorganized, complex arrays of medical data and transforms that data into actionable information and clinical insights – all within the physician’s workflow.
AI coding tools promise speed and revenue. Medicomp’s David Lareau on the rework, denial and audit costs they can add. AI-generated diagnosis and procedure codes can raise claim volume and …Continue
The Bottom Line CMS-0057-F requires payers to support FHIR-based electronic prior authorization by January 1, 2027, but faster exchange won’t shorten the process if providers still assemble medical necessity documentation …Continue
