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Alliance Coding Work Group, April 2019: Health New England

Event Date:4/4/2019

Event Overview

Thursday, April 4, 2019
1:00 p.m. CT – 2:30 p.m. CT (90 minutes)
Hosted by: Health New England

This event is hosted in our ReadyTalk platform.

The Alliance Coding Work Group brings together individuals within Alliance member health plans, health systems or provider groups who have responsibility for coding, documentation or other activities related to RADV audits for Medicare Advantage and Commercial/Exchange products. Each call is hosted by a health plan that will share a selection of medical charts with the group for feedback on risk adjustment coding best practices.

The medical charts are shared at least two weeks in advance of each call. Participants should review the charts, complete the pre-work questions and come prepared to share how they would code each chart and supporting documentation source(s), if applicable.

Remaining time will be used for open discussion.


Audience

Certified coders and managers with responsibility for the oversight of coders, as well as plan staff with responsibility for physician training around accurate and specific documentation related to coding.


AAPC and AHIMA CEUs 

AAPC: This event has been approved by the AAPC for 1.5 CEUs.

AHIMA: The program has been approved for 1.5 continuing education unit(s) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor. 


Ask your peers a question or share a resource anytime through the Alliance discussion forum

You can visit the discussion forum and post a question anytime. It's only available to Alliance members, so you question is private and secure. When submitting a question, you can select which topics your question is related to, such as "risk adjustment" or "coding". Individuals who have indicated in their Alliance profile they are interested in those topics and are opted in to discussion forum emails will receive your question. You can also add an attachment to your question or reply, making this tool another great resource for sharing best practices with your peers.

Post a question  |  Learn more about the discussion forum

 


Upcoming risk adjustment/coding events

06/06/2019

Alliance Coding Work Group, June 2019: SelectHealth

08/08/2019

Alliance Coding Work Group, August 2019: Medical Associates Health Plans

10/10/2019

Alliance Coding Work Group, October 2019: Health Alliance Plan

12/05/2019

Alliance Coding Work Group, December 2019: Sentara Health Plans

Documents
  • 3/21/2019
  • April 2019 Coding Work Group Case Studies
  • Health New England shares recently coded charts and questions to facilitate discussion on risk adjustment coding best practices during the April 4, 2019 Coding Work Group Session.
Attendees

Below is a list of all delegates registered to date for this event

  • Allen Chen
  • ALLIANCE GUEST
  • Director of Network Operations at Central Health Plan of California
  • Annie Shieh
  • ALLIANCE GUEST
  • Senior Compliance Counsel at Central Health Plan of California
  • Dega Abdi
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Auditor at Mount Carmel Health Plan (MediGold)
  • Ann Adams
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Business Analyst at Scott & White Health Plan
  • Lisa Alexander
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior Coding Analyst at Health Alliance Medical Plans
  • Lori Asmus
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Risk Adjustment at Network Health
  • Amy Atkins
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Medical Records Specialist at Community Health Plan of Washington
  • Kelly Baker
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Clincal Code Reviewer at Presbyterian Health Plan
  • Gay Ball
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • MRA Project Manager at Cone Health
  • Julie Bartels
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Analyst at Quartz Health Solutions
  • Michael Baumann
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Business Analyst at Scott & White Health Plan
  • Jennifer Berringer
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Lead Health Risk Coding and Education Specialist at Health Alliance Plan (HAP)
  • Veronica Bickford
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Code Reviewer at Presbyterian Health Plan
  • Sandra Blair
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Supervisor, SIU at Scott & White Health Plan
  • Christine Bogert
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coder II at Geisinger Health Plan
  • Pamela Bower
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Program Manager, Risk Adjustment at Presbyterian Health Plan
  • Sibyl Boyd
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Medical Department Coordinator at Cox HealthPlans
  • Bill Bradish
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior Investigator at Presbyterian Health Plan
  • Dalene Brandenburg
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Project Coordinator at Health Alliance Medical Plans
  • DeeEl Brovetto
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Auditor II at Scott & White Health Plan
  • Sarah Burke
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Quality Auditor at Health First Health Plans
  • Kristin Calkins
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Analyst at Quartz Health Solutions
  • Heidi Campbell
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • CDI Specialist at Henry Ford Health System
  • Elizabeth Carman
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • SIU Nurse Auditor at Presbyterian Health Plan
  • Stefanie Carroll
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Sr. Claims and Reimbursement Specialist at Community Health Plan of Washington
  • Charniece Carter
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Quality CHA Auditor at Health First Health Plans
  • Kayleigh Cavano
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Auditor at Mount Carmel Health Plan (MediGold)
  • Ashley-Jo Chapin
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Compliance RN at Geisinger Health Plan
  • Brenda Chavez
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Auditor at Health New England
  • Jackie Chu Shing
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adustment Coding Auditor at SelectHealth
  • Tina Chyko
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • GHP Coder III at Geisinger Health Plan
  • Wynda Clayton
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Manager at Providence Health Plans
  • Kerstin Conner
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Clinical Delegation Auditor at Mount Carmel Health Plan (MediGold)
  • Deb Curry
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Manager at Paramount Health Care
  • Sara Curry
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coder III at Geisinger Health Plan
  • Anelladee de Leon
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • System Configuration Analyst CPC at Presbyterian Health Plan
  • Colleen Degenhardt
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Analyst at Quartz Health Solutions
  • Michelle Dietterick
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Clinical Transformation Educator at Geisinger Health Plan
  • Crystal Djordjevic
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Consultant at Health Alliance Medical Plans
  • Diana Dlubala
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Outpatient Coder at Sentara Health Plans (Optima)
  • Michelle Dunning
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Configuration Coordinator at Presbyterian Health Plan
  • Teya Enerson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Sr. Claims Coding Associate at Indiana University Health Plans
  • Kathleen Engel-Chapman
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Quality CHA Auditor at Health First Health Plans
  • Doris Ewing
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding Analyst at Health Alliance Medical Plans
  • Michelle Faniola
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Program Integrity Investigator III at Presbyterian Health Plan
  • Kristine Forrest
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Provider Educator at Health Alliance Plan (HAP)
  • MELISSA GAIR
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • CODER 1 at Geisinger Health Plan
  • Lisa Garrett
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Manager at Sentara Health Plans (Optima)
  • Evie Gill
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding Analyst at Health Alliance Medical Plans
  • Amanda Gingrich
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coder II at Geisinger Health Plan
  • Tara Grasley
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coder at Geisinger Health Plan
  • Lori Harris
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Medicare Advantage Coder at Health Alliance Plan (HAP)
  • Janet Hill
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Compliance Coordinator at Paramount Health Care
  • Freda Hogan
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP Network Development at Health Alliance Plan (HAP)
  • Shelly Huang
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coder at Chinese Community Health Plan
  • Jenny Hudson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • OP CDI SPECIALIST at Henry Ford Health System
  • Amy Jack
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Auditor Supervisor at SelectHealth
  • Karen Jensen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Risk Adjustment at Quartz Health Solutions
  • Morgan Johnson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Auditor at SelectHealth
  • Erin Kalagher
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Specialist at Health New England
  • Erin Kavanagh
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coordinator at Samaritan Health Plans
  • Kaesie Kettinger
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coder at Paramount Health Care
  • Kaitlin Knapik
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Auditor at Mount Carmel Health System
  • Kathy Koontz
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Analyst at Health First Health Plans
  • Sarah Larence
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Benefit Configuration Sr. Analyst at Presbyterian Health Plan
  • Melissa Lavaki
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Associate Coding Analyst at Providence Health Plans
  • Anji Lefler
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Auditor at SelectHealth
  • Kathleen Letterman
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coder II at Geisinger Health Plan
  • Rhonda Long
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding Analyst at Health Alliance Medical Plans
  • Stephanie Long
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Health Risk Coding & Education Specialist II at Health Alliance Plan (HAP)
  • Amy Mann
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Configuration Specialist at Avera Health Plans (DAKOTACARE)
  • Peggy Manser
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Health Risk Coding and Education Specialist II at Health Alliance Plan (HAP)
  • Glenda McClung
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding Specialist at Paramount Health Care
  • Maria Menendez
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • RN/CPC/CRC/clinical reviewer at AvMed
  • Cassandra Micsinay
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coder II at Geisinger Health Plan
  • Tammy Miller
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Business Analyst at Scott & White Health Plan
  • Meghan Miller
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk adjustment auditor at Scott & White Health Plan
  • Julie Miller
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • coding analyst at Health Alliance Medical Plans
  • Stephne Morgan
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding Specialist at Health New England
  • Jacqueline Morris
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding Analyst II at Providence Health Plans
  • Deana Myers-Voyk
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding Auditor at SummaCare
  • Cathy Nagy
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Risk Adjustment Coding and Education at Health Alliance Plan (HAP)
  • Sandra Nary
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Clinical Auditor at Neighborhood Health Plan of Rhode Island
  • Donna Norero
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Clinical Coding Reviewer at Presbyterian Health Plan
  • Jaylene Olson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Sr. Coding Analyst at Health Alliance Medical Plans
  • Michelle Osborne
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Outpatient Clinical Documentation Specialist at Henry Ford Health System
  • Jana Pennington
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Analytics Manager-Coding at Saint Luke's Health System
  • Robin Perry
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding Consultant at Health Alliance Medical Plans
  • Joyce Petermann
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding validator/risk adjustment specialist at Avera Health Plans (DAKOTACARE)
  • Sonia Pi Fane
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • RN at AvMed
  • Deborah Pickering
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Specialist at Paramount Health Care
  • Lisa Potter
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment coder/ MA Abstract Analyst II at Health Alliance Plan (HAP)
  • Alix Putnam
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Auditor I at SelectHealth
  • Kylie Rasmussen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Auditor at SelectHealth
  • Viktoriya Rebrik
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Sr. Claims Reimbursement and Coding Specialist at Community Health Plan of Washington
  • Kristen Reed-Pearson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding Analyst II at Providence Health Plans
  • Monday Reynolds
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Certified Coder at Santa Clara Family Health Plan
  • Jill Reynolds
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment analyst at Providence Health Plans
  • Heather Richardson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Quality Assurance Analyst, CPC at Physicians Health Plan
  • Patricia Rivera
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • System Configuration Analyst - CPC at Presbyterian Health Plan
  • Kimberly Romero
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Clinical Coding Reviewer at Presbyterian Health Plan
  • Katherine Ross
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Fraud, Waste and Abuse Analyst at Paramount Health Care
  • Lorie Rothermel
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adj Coder II at Geisinger Health Plan
  • Kristy Russell
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Auditor II at SelectHealth
  • Ivis Salgado
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Clinical Reviewer at AvMed
  • Wilfrieda Schultz
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coder at Community Health Options
  • Elizabeth Shubitowski
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Health Risk Coding & Education Specialist II at Health Alliance Plan (HAP)
  • Bryan Smith
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coder at Paramount Health Care
  • Rochelle Smith
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Auditor I at SelectHealth
  • Valerie Steen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Sr. Claims Reimbursement and Coding Specialist at Community Health Plan of Washington
  • Ashley Stipanovich
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Auditor I at SelectHealth
  • Betsy Thompson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Configuration Analyst - Certified Professional Coder at Presbyterian Health Plan
  • Kayla Tommeraasen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Configuration Specialist at Avera Health Plans (DAKOTACARE)
  • Tana Turner
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Auditor at SelectHealth
  • Desiree Walke
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Analyst at Quartz Health Solutions
  • Kimberly Watkins
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Auditor III at Intermountain Healthcare
  • Mary Wertz
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • HCC Coding Auditor Manager at Presbyterian Health Plan
  • Mandy Whitley
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding Analyst at Health Alliance Medical Plans
  • Tanya Williams
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding Consultant at Health Alliance Medical Plans
  • Julie Yohe
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coder at Geisinger Health Plan
  • Jade Youngblood
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Specialist at Paramount Health Care
  • Halei Zhu
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Population Health Data Analyst at Health New England
  • Jenna Zimmerman
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coder lll at Geisinger Health Plan
Speakers