Oct 9, 2023 | Healthcare Compliance
SunHawk Consulting, LLC is excited to announce that Lorraine Aniello and Leah Lane will be presenting on the topic of “A Case Study in Consequences of Insufficient Due Diligence in Medical Practice Acquisition” at the Clinical Practice...
Aug 23, 2023 | Healthcare Compliance
SunHawk Consulting, LLC is excited to announce that Lorraine Aniello and Leah Lane will be presenting on the topic of “A Healthcare Study in Fraud and Collaboration with Clinical and Medical Coding Teams” at the Clinical Practice Compliance Conference,...
Jul 13, 2023 | Healthcare Compliance
In our previous article, we explained how Risk Adjustment is a “partnership” between the patient, the provider, the insurance plan (Plan), and the governmental entity. So, which partner in this process holds the “risk”? Governmental Entity: The governmental entity has...
Jul 5, 2023 | Healthcare Compliance
Under the risk adjustment (RA) model, reimbursements to the insurance companies (Plans) are based on the member’s level of severity of illness rather than the number and types of interventions the member receives throughout the year. This reimbursement model is based...
May 2, 2023 | Healthcare Compliance
This article, as part of the SunHawk Consulting team’s Medical Risk Adjustment compliance as well as statistical sampling & coding audit services, gives a high level overview of some upcoming changes for 2024 in the CMS Risk Adjustment model, V28. The CMS-HCC Risk...
