The main difference between MedPAC and CMS estimates of uncorrected coding intensity is that MedPAC’s estimate accounts for the upward trend in coding intensity.

Some limits on how the assessments are used for adding new diagnosis codes might be justified to ensure Medicare Advantage plans aren’t overpaid, researchers wrote. Under MA, insurers contract with ...

Denials and poor follow-up processes. Charge entry errors. Accounts receivable (A/R) days well above industry standards. High self-pay balances. Failure to negotiate or load payor contracts.