HEDIS Preparation Guide: 3 Essential Steps
HEDIS (Healthcare Effectiveness Data and Information Set) is a critical quality measurement tool used to assess healthcare performance across various domains. For healthcare organizations, the HEDIS season, which typically spans February to May, requires a proactive...
Navigating QPP Reporting in 2025: Finding the Best Path for Your ACO
Mandatory Alternative Payment Model Performance Pathway (APP) reporting begins this year, bringing significant changes for Accountable Care Organizations (ACOs). As we move into this new reporting era, the question isn’t whether to act but how to act effectively....
What Payers Need to Know to Stay Ahead in 2025
2025 has arrived and with it brings new challenges and potential opportunities to the healthcare landscape. Payers face increasing regulatory demands, heightened expectations for interoperability, a renewed focus on payment integrity, and rising pressure to address...
Why Investing in Internal Auditing Tools is Key to Reducing Coding Risks and Financial Losses
As the healthcare industry faces increased scrutiny, especially in medical coding accuracy and regulatory compliance, recent surveys reveal that many professionals are concerned with issues like upcoding, audit discrepancies, and the integration of artificial...