Care Decoded Podcast
The ultimate podcast that simplifies the complex world of risk adjustment, coding, and clinical technology – so providers and health plans can work smarter, not harder. Hosted by the team at Inferscience.
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Welcome to the very first episode of Care Decoded, where we peel back the layers of healthcare innovation with people who are reshaping the industry from the inside. In this episode, Dr. Sunil Nihalani, Founder and CEO at Inferscience, dives into his unconventional journey from his childhood in India where his family was far from medicine to the creation of Inferscience, a company dedicated to making risk adjustment and clinical documentation more efficient for physicians and payers.
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In this episode, host Dr. Sunil Nihalani is joined by Subbu Ramalingam — a seasoned former health plan executive and expert at the intersection of star ratings, risk adjustment, and healthcare quality. Together, Sunil and Subbu dig into why star ratings aren’t just about checking boxes, but about truly improving patient care and experience. They discuss how health plans and providers can bridge the often-siloed worlds of risk adjustment and quality improvement and why accurate data and collaboration are key to better — and more meaningful — outcomes.
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In this episode, host Lucy Medina sits down with Dr. Sunil Nihalani, CEO of Inferscience and practicing physician, to tackle a topic that hits close to home for every clinician: documentation burnout. Together, they pull back the curtain on how clunky EHR systems, endless documentation demands, and poorly designed workflows are taking a toll not just on clinicians’ efficiency but also on their emotional well-being, patient relationships, and even financial outcomes.
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In this episode, hosts Dr. Sunil Nihalani and Biodun Kajopaiye (BK), Risk Adjustment and Stars Manager at CareFirst BlueCross BlueShield, dive into the seismic changes brought about by version 28 of the CMS HCC risk adjustment model. Whether you’re a seasoned pro or new to the world of risk adjustment, this episode will break down exactly what V28 is, how it’s shaking up provider and health plan workflows, and why specificity in documentation is more crucial than ever.
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In this episode, host Michael Lesnik, VP of Provider Sales at Inferscience, sits down with Dr. Sunil Nihalani, CEO of Inferscience and a practicing physician, to unravel the complexities of “care gaps”, those critical yet often overlooked opportunities to improve patient care and outcomes.
Drawing on over fifteen years of experience in healthcare IT and value-based care, Michael and Dr. Nihalani dive deep into why care gaps persist, the challenges providers face in closing them, and why it’s about more than just checking a box on a metric sheet.
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In this episode, host Mark McKeown is joined by renowned risk adjustment and coding expert Colleen Gianatasio to kick off a special two-part series diving into CMS’s heightened focus on RADV (Risk Adjustment Data Validation) audits. As Medicare Advantage plans face unprecedented scrutiny with CMS now pledging to audit all eligible contracts every year, the stakes have never been higher for compliance, documentation, and risk management.
Together, Mark and Colleen unravel the far-reaching impact of these changes across the healthcare industry, from the increased resource demands on health plans to building a culture of compliance and leveraging people, process, and technology for audit readiness.
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In this episode, we dive into the second part of our RADV miniseries, shifting focus from what RADV is, to the crucial role of frontline providers in ensuring accurate, defensible documentation as part of everyday care. Host Mark McKeown is joined once again by Colleen Gianatasio, an expert in risk adjustment and value-based care with over 20 years of experience. Together, they explore why provider documentation is the foundation for RADV compliance, the biggest barriers clinicians face in meeting documentation requirements, and how the right technology, like AI-driven coding support, can help bridge the gap between compliance demands and real-world clinical practice.
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