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Tune in to Current Trends for Payers podcast for insider insights and perspectives from the top experts in our industry. Listen to audio interviews and discussions on current trends, innovations, and topics that matter in the world of health plan operations
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S4E4
Pay Now or Pay Later: Whistleblower Lawsuits and Risk Adjustment
This episode unpacks several DOJ cases that reveal how coding shortcuts, unsupported diagnoses, and non-compliant queries can escalate. From internal governance gaps to coding-policy breakdowns, the message is clear: vendor oversight is a necessity
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