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With utilizing AI in healthcare, we must analyze LLMs, the inputs, and the outcomes as we continue to evolve them with discretion and critical thinking.

Improve risk adjustment accuracy with Jiva's Risk Adjustment Navigator, a comprehensive solution that can increase financial success and quality care.

To effectively navigate the complexities of risk adjustment in federally sponsored healthcare, a combination of operational strategies and technology is vital.

With the Jiva platform's configurable Sentinel Rules Engine (SRE), health plans can use automation to effectively prioritize, sort, and manage the case load.

For federal authorities, reducing risk adjustment overpayments and noncompliant coding practices are critical to the sustainability of the healthcare system.

Patient Access and Interoperability bring hundreds of payers and app developers into an emerging ecosystem that will continue to mature.

Learn how current risk adjustment methodologies have unintentionally caused overpayments for federally sponsored healthcare funding.

Learn why API testing & certification programs confirm the ability to fully conform to the FHIR standard and enable interoperability in a scalable manner.

Medicaid is the largest health insurance program in the U.S., covering approximately one in five Americans. That equates to 82.3 million low-income Americans, including millions of children, older adults, people with disabilities, and two million veterans. Medicaid is the single

Claw Backs and Beneficiary Protections in the Form of CMS Regulatory Changes – Massive Financial Implications

Much of the direction of the 2020 proposed rule is in the new proposed rule, particularly the sharing of prior authorization decisions/status with patients.

The Centers for Medicare and Medicaid (CMS) released the 2024 Medicare Advantage Proposed Rule on December 14, 2022 and the 957 page document is scheduled to enter the federal register on December 27th, 2022.

To reduce the burden of the prior authorization, many providers and payers have come together to develop solutions. Learn more.

opulation health initiatives aim to help patients maintain optimal health and ultimately save money by managing and preventing disease.