Welcome to RISE

Resource Initiative and Society for Education

Welcome to the home of the Resource Initiative and Society for Education (RISE). RISE is the first national association totally dedicated to enabling healthcare professionals to meet the challenges of managed healthcare. We strive to serve our members on four fronts: Networking, Education, Jobs and Industry Intelligence. Please explore our website and the resources it provides. Those wanting to join the association are invited to complete and submit an application. Take a look at the benefits and services of membership. 

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Latest Posts

RISE Sponsor Directory

I have been asked this question several times. We compiled the attached directory so you would have access to that information at your finger tips. All you need to do is click on this link and you can download the directory. We will update and revise as changes occur, so keep checking in with us: ...
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Fred Schulte Asks, "Why Not Extrapolate?"

If you have missed his series of articles in the Center for Public Integrity website, you will want to make his acquaintence with his appearance on an National Public Radio article (see link below). I received a call from Fred last week and we explored the issue of extrapolation penalties for Medicare Advantage RADV audits. In short, Fred's contention is that there is "upcoding" of procedure codes for FFS Medicare billing that is subjected to OIG audits and subsequent extrapolation penalites, which should be the same standard applied to diagnostic "upcoding" under Medicare Advantage. This means that any errors discovered in a RADV audit would be subject to a penalty that is extrapolated across the whole population: chart audit confirmation of diagnostic codes would have zero tolerance for non-validation. ...
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Upcoming Conference

 

RISE California

You’ll hear directly from expert resources, including CMS and NCQA speakers and folks in the trenches who will share first-hand experiences. Plus, we’ve added a special session featuring the RISE Advisory Board and their take on CMS policy changes.

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Upcoming Webinar

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