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Article
What’s up with “upcoding”?
Although upcoding fraud is a concern for payers, its impact on claims data for mortality risk assessment is negligible.
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Article
Cystic fibrosis is an improving condition—put your guidelines on notice
Heads up, forward-thinking underwriters: Treatment for CF is dramatically increasing patient longevity.
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Article
HIV is a manageable condition—do your guidelines know that?
HIV has gone from crisis to chronic. It demands the same risk-assessment rigor as other chronic conditions.
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Article
Hepatitis C is curable—do your underwriting guidelines know that?
You can confidently issue business to this cohort. Here’s how to adjust your risk models.
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Report
State of the Data 2025: Irix Prescription Data Report
The OG insurtech tool has quietly grown into a multipurpose risk-assessment powerhouse. How well do you really know it?
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White Paper
Retro study: EHR vs EHR+APS
Munich RE found that the decisions underwriters made on the basis of EHR data were rarely changed when reappraised with the benefit of additional APS data.
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White Paper
Quantifying the value of new-member HCC coding improvements to ACA plans
Accurately coding new members improves patient outcomes and an ACA plan’s bottom lines. The proof is here, in a formula you can apply yourself.
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