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Risk Adjustment Reality Check: What’s Working—and What Isn’t

Listen to the podcast.  This year has been something of a reckoning for Medicare Advantage. Senator Grassley’s scathing report of UHG’s risk adjustment practices, and the Kaiser $556 million settlement to resolve False Claims Act allegations…

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Do you follow the GOLD standard for COPD diagnosis and management, mid-revenue cycle professionals?

By Brian Murphy Are you following the GOLD standard for COPD diagnosis and management? Medscape has a great article and video on this underreported diagnosis…

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Norwood publishes analysis of CMS 2027 Advance Notice

Download the guide here. Medicare Advantage just shifted again — and 2027 is already reshaping your 2026 strategy. If you think the 2027 Advance Notice…

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Morbid obesity vs. Class 3 obesity for medical coding: Which to use—and which is accepted?

By Brian Murphy A mid-revenue cycle professional lamented on a recent call that their CDI program is hindered because physicians don’t want to diagnose “morbid…

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A reckoning for Medicare Advantage: Inside the Kaiser case with Mary Inman and Liz Soltan

Listen to the episode here. Medicare Advantage is undergoing a reckoning … and that reckoning is coming from within. In January Kaiser Permanente affiliates agreed…

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