Friday, November 11, 2022

There is a major crackdown on fraudulent or inaccurate risk-adjustment scores, with an increased number of RADV audits and OIG audits. Negative media attention and Lawsuits damaged the reputation. There is a need to shift processes to look both ways, stay compliant and get ahead of audits before they happen. Risk Adjustment Solutions HCC Compass is World’s first personalized AI Powered Risk Adjustment Coding & Audit Platform. Now leverage natural language processing (NLP) and deep learning (DL) and look at clinical charts and claims both ways (ADDs and DELETEs) to capture a complete, defensible picture of member/patient risk.

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