Wolters Kluwer introduces Regulatory Audit Module to improve risk adjustment audit validation rates using AI
WOLTERS KLUWER S/ADR (WTKWY)
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Source: Business Wire
Health plan compliance teams can now access the first AI-enabled comprehensive audit support solution on the market as part of Coder Workbench WALTHAM, Mass.--(BUSINESS WIRE)--Health plans are under greater scrutiny, navigating an increasingly complex regulatory environment. The Centers for Medicare and Medicaid Services (CMS) estimates $4.7 billion will be recovered from Risk Adjustment Data Validation (RADV) audits, including extrapolation, from 2023 through 2032. To help mitigate this risk, Wolters Kluwer Health has introduced the Regulatory Audit Module as part of its Risk Adjustment solution.The new module is specifically designed to support Medicare Advantage Organizations (MAOs) during regulatory audits. The Regulatory Audit Module leverages clinically trained artificial intelligence (AI) to increase the efficiency and accuracy of risk adjustment auditing, helping reduce repayment liability by identifying an average of 5-7% additional codes.Going beyond manual auditing and c
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