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The Court Just Ruled on Medicare Advantage Audits. Here's Why That's Your Problem.
A federal court blocked CMS statistical extrapolation in RADV audits, but provider documentation requirements remain unchanged. AI-powered fraud detection, payment suspensions, and multiple audit programs continue unaffected. Learn what the ruling actually changed, what didn't, and how to prepare during the 6-12 month window before CMS responds. Get your RADV preparedness roadmap and documentation defense strategy.
Adi Tantravahi
Oct 20, 20253 min read


A VP of Revenue Cycle's Strategic Guide to DRG Downgrades
Payer AI systems are processing audits 24/7, targeting high-value DRGs like sepsis and respiratory failure. Learn how revenue cycle leaders are fighting back with AI-powered appeal workflows that reduce processing time by 80-90%, increase appeal volume 3-4x, and turn audits into competitive advantages. Discover implementation strategies, key metrics, and ROI frameworks to modernize your denial management program.
Adi Tantravahi
Jun 4, 20258 min read
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