10 CDI Leaders Share Best Practices for Concurrent Review Implementation
Why Concurrent Review Implementation is Crucial? Concurrent Review has become one of the most critical levers for strengthening Clinical Documentation Integrity (CDI) programs in 2026. As payer scrutiny intensifies, denial rates rise, and quality outcomes directly influence reimbursement, CDI leaders like you, HIM Directors, CDI Directors, and VPs of Revenue Cycle, are asking one core […]
6 Steps to Prepare for the CMS HCC Model V28 – 2026
Understanding the 2026 V28 Cliff In 2026, the Centers for Medicare & Medicaid Services (CMS) will finalize the three-year transition to the V28 risk adjustment model, ending the era of blended V24/V28 scoring. For Payment Year (PY) 2026, 100% of RAF scoring will be based on V28, meaning V24 codes will disappear overnight from reimbursement […]
One Misstep. One Service Line. $11.7Million Lost. Why 100% AWV Coding Review Is Non-Negotiable
Why Penn State Health Paid a Penalty? Penn State Health (PSH) recently paid over $11.7 million to resolve voluntarily self-disclosed violations related to Medicare claims for Annual Wellness Visit (AWV) services. The settlement serves as a stark reminder: even well-intentioned healthcare organizations can face devastating financial consequences when AWV documentation and coding fall short of […]
When “More” Doesn’t Mean “Moderate”
When “More” Doesn’t Mean “Moderate” Understanding the Acute Problem Riddle in MDM. Let’s be honest — it makes sense to assume that if a patient shows up with four acute problems, the visit should reflect a higher level of complexity. After all, managing multiple complaints takes more time, focus, and decision-making, right? That’s where the […]
A Time to Reflect & Look Ahead
In American corporate culture, the final week of the year often serves as a time for reflection and big-picture thinking. At Chirok, we take this opportunity to review all our decisions through the lens of our core value: improving revenue cycle performance according to each client’s unique definition of success.
Luddites, Nurse Practitioners, and Driverless Cars Inform the Impact of AI on Healthcare
The arrival of artificial intelligence (AI) in healthcare raises pressing questions about the future of the healthcare workforce, professional guilds, and industry-wide best-practice. What lessons can we glean from history to better understand the opportunities and risks?
Evaluating the role of AI in value based care premium adjustment
This study aims to understand the ways in which augmenting AI with clinical reviewers can unlock faster adoption, increase efficiency, and improve compliance in the HCC coding process. Probing the relative benefit of AI versus augmenting with service-based solutions is especially relevant.