IBX’s $22.5M Settlement: A Chart Review Compliance Lesson
A $22.5M settlement shows how a chart review program meant to catch bad diagnosis codes can itself become the liability when findings aren’t acted on.
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CMS’s PY2024 RADV Audits Raise the Bar for Coders
CMS’s PY2024 RADV audits are underway, and a recent $2.4M settlement shows what happens when HCC codes don’t hold up. Here’s what coding teams need to know.
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Agentic AI Coding Meets RADV Audit Uncertainty in 2026
CMS’s RADV extrapolation appeal is still unresolved. Here’s why risk-adjustment coding teams need agentic AI built for defensibility, not just speed.
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Agentic AI for HCC Coding: Lessons From OIG’s $462M Audit
OIG found every sampled acute stroke HCC code unsupported, a $462M miss. Here’s how agentic AI validation can catch these HCC coding gaps before submission.
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