Blog

Second-Level Review (2LR) Strategies to Mitigate Risk on Final Submission to CMS

The Centers for Medicare and Medicaid Services (CMS) has focused on Risk Adjustment data submissions for many years with Risk Adjustment Data Validation (RADV) audits.  The Office

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Leveraging Technology to Optimize Quality Assurance Strategies

Have you ever thought about the effectiveness of your quality assurance program? Do you use technology to execute best practices? The industry standards identify accuracy requirements by the Centers f

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Talix’s Takeaways on the Recent MA Payment Year 2022 Announcement

In light of various challenges that payers and providers are facing due to the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) issued 2022 Medicare Advantage and Part

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Telehealth Security and Workflow Optimization

As the final blog post in our telehealth series, we will highlight security and workflow considerations for providers to enhance their telehealth platform and integrate it better into existing workflo

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How to Avoid Telehealth Documentation Pitfalls

The year 2020 brought us the novel coronavirus.  In response, our friends at the  Centers for Medicare & Medicaid Services (CMS) stepped up to encourage healthcare providers to adopt tel

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Telemedicine – Healthcare’s New Differentiator

We have seen an exponential growth in the number of telemedicine visits being performed since the pandemic’s arrival on our shores.  While this growth is expected to plateau, telemedicine is

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The Ensuing Challenges of Telemedicine and Reimbursement

Telemedicine has exploded out of necessity to address healthcare needs amidst stay in place constraints,  but it’s created new reimbursement changes especially for the value-based care market.&

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The Coronavirus Pandemic introduces three unforeseen challenges to Health Plan Risk Adjustment Operations

The Coronavirus Pandemic introduces three unforeseen challenges to Health Plan Risk Adjustment Operations. The American healthcare industry will undergo significant disruptions as the coronavirus cris

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5 Tips for Selecting Your Second-Level Chart Review (2LR) Vendor Infographic

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 mis

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Finally, Machine-Learning in Health Care

Some tech buzzwords stir up excitement in some people but mostly trepidation.Artificial intelligence (AI) and machine learning (ML) are two of those terms. Those who understand the benefits of AI

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How Intelligent Analytics Increase Quality and Lower the Costs of 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. Budgeting

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Optimize Data with Patient Data Analytics in Medical Coding

Technology has allowed for new and innovative ways to capture a more conclusive look at member health data.  Data can be powerful when handled properly; however,  many healthcare organizatio

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3 Tips to Thwart Healthcare System Hackers

Over the past few years, healthcare IT systems have faced significantly more cyberattacks than any other industry—and the reasons why are pretty simple: Healthcare hacks have a greater pay off.

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4 Critical Advantages to Deciphering Data with NLP

By now, most health plan providers are aware that an efficient risk adjustment program is the key to maximizing reimbursements and improving patient care. But what’s the best way to

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2019 – Year In Review

As this year comes to a close, it’s time to take a look back at my predictions for 2019 and see just how right (or wrong) I was. Last year,

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