As regulatory pressures intensify and the demand for measurable ROI grows, health care organizations are rethinking how they approach risk adjustment. The landscape is shifting—from retrospective reviews to real-time, proactive strategies powered by smarter technology and deeper clinical insight. In this 38-minute episode of RISE Radio, senior leaders from Cotiviti and Edifecs share how their recent partnership is fueling a new era of innovation across the full risk adjustment lifecycle. From...
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As regulatory pressures intensify and the demand for measurable ROI grows, health care organizations are rethinking how they approach risk adjustment. The landscape is shifting—from retrospective reviews to real-time, proactive strategies powered by smarter technology and deeper clinical insight. In this 38-minute episode of RISE Radio, senior leaders from Cotiviti and Edifecs share how their recent partnership is fueling a new era of innovation across the full risk adjustment lifecycle. From...
Episode 26: What to know about the new era of RADV audits
RISE Radio
17 minutes
2 months ago
Episode 26: What to know about the new era of RADV audits
Medicare Advantage plans are about to face unprecedented scrutiny as the Centers for Medicare & Medicaid Services (CMS) implements a dramatically expanded approach to RADV audits. Starting in 2025, every Medicare Advantage plan will be subject to contract-level RADV audits—a significant departure from the historical approach of randomly selecting 60 plans annually. During this 17-minute podcast, Deborah Curry, risk adjustment programs director at Medical Mutual. breaks down the cri...
RISE Radio
As regulatory pressures intensify and the demand for measurable ROI grows, health care organizations are rethinking how they approach risk adjustment. The landscape is shifting—from retrospective reviews to real-time, proactive strategies powered by smarter technology and deeper clinical insight. In this 38-minute episode of RISE Radio, senior leaders from Cotiviti and Edifecs share how their recent partnership is fueling a new era of innovation across the full risk adjustment lifecycle. From...
