Health Plan Alliance officially kicks off our Coding Work Group: We’ve applied for CEUs with AAPC and AHIMA

Kristin Rodriguez, Health Plan Alliance

04/11/2016

The Health Plan Alliance has officially kicked off our coding work group, an educational webinar series designed for individuals within Health Plan Alliance member health plans who are certified coders a/or supervising certified coders, and who have responsibility for coding, documentation and other activities related to RADV audits for MA and/or the ACA products.  We have applied for CEUs with both the AAPC and AHIMA and hope that members participating could earn between 5 and 7 CEUs.  As with all Alliance programming, there is no cost to participate.

Educational Goals of the webinar series:

  • The curriculum is designed to assist certified coders in making appropriate decisions when it comes to coding particularly challenging documentation, through multiple, de-identified case examples presented during each session.
  • Experienced CMS audit participants will speak to documentation that was accepted or NOT accepted by CMS
  • The work group curriculum will assist in the development of best practices and documents them, thereby developing a knowledge library to benefit all Alliance member health plans looking for coding resources and support
  • Particular areas of focus: Accurate documentation and appropriately noting diagnostic codes supported by that documentation; cross walking diagnostic codes to HCCs

We've scheduled a series of webinar events and the registration links are noted below.  To attend, simply select the links and register using our online registration tool.  If you need assistance doing so, view our Website FAQ page.

April 28 at 11:30 am CT

June 2 at 11:30 am CT

July 28 at 11:30 am CT

September 15 at 11:30 am CT

November 3 at 11:30 am CT

Each work group call will showcase one health plan at a time, whose team is responsible for sharing two case studies with the other group members for discussion.  

  • The case study, de-identified charts will be shared at least two weeks in advance of the call, 
  • Participants will review the charts in advance and bring documentation regarding how they would code and why.  
  • The discussion will be moderated by the named facilitator from that plan, who will summarize input and ultimately phrase the best practice identified. 
  • The goal of each call is to arrive at a resolution for each “problem chart,” and document that resolution for the benefit of all Alliance members, with referenced literature/materials substantiating the decision.  
  • Alliance staff will assist in preparing the final documentation from each call, and the facilitator will review for accuracy prior to posting to the member website.
  • Any remaining time during the call will be available for open discussion, which could be used to:
    • Review the most recent online conversations between coders on the Alliance website.
    • Best practices could be called out and highlighted, with additional clarification and discussion as needed
  • Each session will have a named facilitator, who has the appropriate credentials to assure the AAPC/AHIMA the session’s content is accurate and reflects the most up-to-date guidance.  For each member plan “hosting” a call, the staff member on point will be appropriately credentialed.

Also, we have created a collaboration site for this coding work group.  It is available to all Alliance members, and curates the materials and events associated with our efforts.  You can visit this page directly, and can find the page link at any time by clicking the shortcut on the website's footer, titled "Alliance work group and committee members' private portal."

Interested in joining this work group?  It’s easy!  Step 1: register to attend the work group webinar calls by clicking the hyperlinks to each event, above.  Step 2: Visit your people profile on the Alliance member website and update your “Areas of Interest” to include a new category called "risk adjustment coding work group."  Opt in to communications regarding this work group by simply selecting that box in your areas of interest.  Feel free to forward this information on to individuals you think have this interest, so they can join in the conversations.