Harmony Insight

Healthcare is evolving faster than ever—and sometimes it feels like payers, providers, and patients are all moving in different directions. But what if better alignment could improve patient care and system efficiency? Watch this recent webinar where Harmony Healthcare hosts the BSW Outpatient Clinical Documentation Integrity team for a thought-provoking, one-hour discussion on how demographic shifts and risk adjustment strategies are reshaping the way we deliver, document, and optimize care. You’ll learn how to: Understand the demographic trends influencing Medicare and provider priorities Identify the hidden challenges driving costs and inefficiencies across the care continuum Align documentation practices with patient needs to…

Harmony Healthcare provides healthcare organizations with the talent and resources needed to succeed today as well as the foresight to prepare for tomorrow’s challenges. In this employee spotlight, we’re excited to highlight Kathy Pride, Director, Coding Solutions. We spoke with Kathy to share her advice for clients and coding professionals as well as insights from her career journey. 1. Tell us about your journey in healthcare? My introduction to healthcare began when I was a unit secretary in a hospital. Although that role wasn’t the right fit, it led me to return to school, where I discovered the field of…

Centers for Medicare and Medicaid Services (CMS) issued a press release at the end of May stating that they will be ramping up Risk Adjustment Data Validation (RADV) audits. There will be 2000 coders auditing 200 patient charts across 550 Medicare Advantage (MA) plans. The numbers are up from 40 coders auditing 35 patient charts across 30 MA plans prior to these planned audits. These retrospective reviews will occur from 2018-2024 and should be completed by early 2026. Extrapolation will occur following the audit to recoup the estimated $17 billion in overpayment to MA plans. Outpatient Clinical Documentation Integrity (CDI)…