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Risk Adjustment Round Table: March 2019 -- FirstCare Health Plans

Event Date:3/14/2019

Event Overview

Thursday, March 14, 2019
1PM CT – 2PM CT (60 minutes)
Hosted by: FirstCare Health Plans and Scott & White Health Plan

This event is hosted on our ReadyTalk platform

 

Join your Alliance risk adjustment peer group for a value call and discussion led by Alliance member FirstCare Health Plans and Scott & White Health Plan.  Our first call of 2019 will feature robust discussion on two tough issues:  First: Challenges with out-of-network providers submitting charts; and Second: Effectively appealing chart coding results with the IVA Auditor.  

This is a value call and so all participants are encouraged to review the topics above and come prepared to share out your plan's approach to these issues.  In addition, come with other questions for your Alliance peers.

 

Audience

This value call is designed for risk adjustment leaders

 


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 your 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.

 


 

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View the presentation materials from these recent events

 

Documents
  • 3/14/2019
  • Presentation: Risk Adj Roundtable - FirstCare Health Plans
  • The risk adjustment peer group discussion, led by Alliance member FirstCare Health Plans and Scott & White, covers two tough issues: First: Challenges with out-of-network providers submitting charts; and Second: Effectively appealing chart coding results with the IVA Auditor.
  • 3/14/2019
  • Recording: Risk Adjustment Round Table March 2019 -- FirstCare Health Plans
  • The risk adjustment peer group discussion was led by Alliance member FirstCare Health Plans and Scott & White. The discussion was on two tough issues: First: Challenges with out-of-network providers submitting charts; and Second: Effectively appealing chart coding results with the IVA Auditor.
Attendees

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

  • 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
  • Jessica Allen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Business Analyst at Scott & White Health Plan
  • Lori Asmus
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Risk Adjustment at Network Health
  • Gopiprasad Athukuri
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager RMRA Data Analytics at Health Alliance Plan (HAP)
  • 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
  • Jennifer Berringer
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Lead Health Risk Coding and Education Specialist at Health Alliance Plan (HAP)
  • Sandra Blair
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Supervisor, SIU at Scott & White Health Plan
  • Glynn Bower
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Finance, Reconciliation at SummaCare
  • Sibyl Boyd
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Medical Department Coordinator at Cox HealthPlans
  • Chaneal Brooks
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Business Intelligence Analyst at CHRISTUS Health Plan
  • Ngoc Bui-Tong
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Health Care Economics at Santa Clara Family Health Plan
  • 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
  • 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
  • Ashley-Jo Chapin
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Compliance RN at Geisinger Health Plan
  • Wynda Clayton
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Manager at Providence Health Plans
  • Jennifer Cones
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Outpatient CDI at Henry Ford Health System
  • Carrie Cramer
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Analyst at Paramount Health Care
  • Deb Curry
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Manager at Paramount Health Care
  • Janice Curtis
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Revenue Analyst at Scott & White Health Plan
  • Colleen Degenhardt
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Analyst at Quartz Health Solutions
  • Linda Dickinson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Quality Management Director at Physicians Health Plan
  • Enrique Dimacali
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Specialist at AvMed
  • Crystal Djordjevic
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Consultant at Health Alliance Medical Plans
  • Rudy Dominguez
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Population Health Managment Process Specialist at Community Health Plan of Washington
  • Jessica Dupont
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Risk Adjustment at Health New England
  • 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
  • Sarah Engle
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior Risk Adjustment Program Analyst at Western Health Advantage
  • Doris Ewing
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding Analyst at Health Alliance Medical Plans
  • Deanna Homer
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Vice President, Pharmacy Operations and Quality Programs at HealthTeam Advantage
  • Jenny Hudson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • OP CDI SPECIALIST at Henry Ford Health System
  • Danielle Jaber
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • AVP-Gov't Programs at Scott & White Health Plan
  • Karen Jensen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Risk Adjustment at Quartz Health Solutions
  • Erin Kavanagh
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coordinator at Samaritan Health Plans
  • Kathy Koontz
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Analyst at Health First Health Plans
  • Nhu LE
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Manager at Presbyterian Health Plan
  • Melanie Lewis
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coder at Henry Ford Health System
  • Luce Lohier
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Enrollment & Premium Services at AvMed
  • Maria Menendez
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • RN/CPC/CRC/clinical reviewer at AvMed
  • Julie Miller
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • coding analyst at Health Alliance Medical Plans
  • 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
  • Stephne Morgan
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding Specialist at Health New England
  • Angela Morningstar
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Health Data at CommunityCare
  • Le'Audry Moultree
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Outpatient CDI Specialist at Henry Ford Health System
  • 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)
  • 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
  • Kari Pace
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Clinical Documentation Improvement Nurse-Risk Adjustment/Quality Management at Medical Associates Health Plans
  • Jana Pennington
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Analytics Manager-Coding at Saint Luke's Health System
  • Lisa Potter
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment coder/ MA Abstract Analyst II at Health Alliance Plan (HAP)
  • Jean Rao
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Pharmacy Manager at Chinese Community Health Plan
  • Monday Reynolds
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Certified Coder at Santa Clara Family Health Plan
  • Heather Richardson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Quality Assurance Analyst, CPC at Physicians Health Plan
  • Ivis Salgado
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Clinical Reviewer at AvMed
  • Kris Trafton
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Risk Adjustment at Geisinger Health Plan
  • Barbara Tyson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • OP CDI Specialist at Henry Ford Health System
  • Desiree Walke
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Analyst at Quartz Health Solutions
  • Kayla Walker
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Auditor II at Scott & White Health Plan
  • Susan Waterman
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Risk Adjustment at Scott & White Health Plan
  • Josh Weisbrod
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP Risk Adjustment at Network Health
  • 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
  • Joan Wilberg
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Healthcare Economics at Indiana University Health Plans
  • Noelle Wilds
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Sr. Data Analyst at Presbyterian Health Plan
  • Jade Youngblood
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Specialist at Paramount Health Care
Speakers