Since 2021, the OIG has issued 24 audit reports, and four of the reports have been published so far in 2023. These audits identified more than $400 million in overpayments, with approximately 72% of audited HCCs not validated / supported within the medical documentation The Office of
Read More →Incomplete or inaccurate data from provider claims impacts risk scores Health plans are held accountable for the accuracy of data submitted to CMS. Often, plans act as data aggregators and submit data generated by providers and third-parties to CMS. Incomplete or inaccurate diagnosis data may lead to
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