Risk Adjustment/Coding Toolkit

NOTE: You must login to your Alliance account to access the articles and resources below. Some content may only be accessible to Alliance members.

 

1/12/2022

MediGold Risk Adjustment Job Descriptions
Shared at the Risk Adjustment Fly-In, February 8-9, 2022.

1/12/2022

MediGold Risk Adjustment Org Chart
Shared at the Risk Adjustment Fly-In, February 8-9, 2022.

10/21/2021

Recording: Coding Work Group 2021, Session 6: Health New England
Collaborate with your Alliance peers on risk adjustment coding best practices. During each session, you'll review a collection of recently coded medical charts provided by the health plan host, vote on how you would code each chart, then discuss the results as a group and share best practices. Remaining time is used for open discussion.

10/4/2021

Pre-Work Packet: Coding Work Group 2021, Session 6: Health New England
Collaborate with your Alliance peers on risk adjustment coding best practices. During each session, you'll review a collection of recently coded medical charts provided by the health plan host, vote on how you would code each chart, then discuss the results as a group and share best practices. The remaining time is used for open discussion.

9/20/2021

Recording: Changes to ICD-10-CM Codes and Guidelines Effective 10-1-2021
Review the most current updates regarding ICD-10-CM Official Coding Guidelines for Coding and Reporting FY 2022 that go into effect on Oct. 1, 2021.

9/16/2021

Presentation: Changes to ICD-10-CM Codes and Guidelines Effective 10-1-2021
Review the most current updates regarding ICD-10-CM Official Coding Guidelines for Coding and Reporting FY 2022 that go into effect on Oct. 1, 2021.

9/7/2021

Recording: Coding Work Group 2021, Session 5: SelectHealth
Collaborate with your Alliance peers on risk adjustment coding best practices. During each session, you'll review a collection of recently coded medical charts provided by the health plan host, vote on how you would code each chart, then discuss the results as a group and share best practices. The remaining time is used for open discussion.

8/19/2021

Pre-Work Packet: Coding Work Group 2021, Session 5: SelectHealth
Collaborate with your Alliance peers on risk adjustment coding best practices. During each session, you'll review a collection of recently coded medical charts provided by the health plan host, vote on how you would code each chart, then discuss the results as a group and share best practices. The remaining time is used for open discussion.

8/17/2021

Presentation: Simplify your medical record processing
Join your Alliance peers for a deeper discussion on this hot discussion forum topic.

8/16/2021

Baylor Scott & White Health Presentation: Coding Clinic, RADV Audit and CMS/HHS Feedback
Connect with your Alliance risk adjustment peers to discuss your top challenges, share your expertise and build your network.

8/16/2021

IU Health Plans Presentation: Show and Tell - Coding Clinic, RADV Audit and CMS/HHS Feedback
Connect with your Alliance risk adjustment peers to discuss your top challenges, share your expertise and build your network.

8/16/2021

SelectHealth Presentation: Show and Tell - Coding Clinic, RADV Audit and CMS/HHS Feedback
Connect with your Alliance risk adjustment peers to discuss your top challenges, share your expertise and build your network.

8/16/2021

Recording: Show and Tell - Coding Clinic, RADV Audit and CMS/HHS Feedback
Connect with your Alliance risk adjustment peers to discuss your top challenges, share your expertise and build your network.

8/3/2021

Article: You’re asking too much of your EHR
MedeAnaltyics shares how true healthcare analytics that pulls data from an EHR can help health plans.

7/21/2021

Presentation: Risk Adjustment KPI Dashboards
Dean Ratzlaff, an actuary at Sentara Health Plans (Optima), is back for a deeper dive into the key performance indicator dashboards he and his team use. During our last session, Dean focused on dashboards and data used outside the department (like executives). During this session, Dean and his colleagues share the dashboards they use within the department during and after an intervention campaign and those used for provider engagement.

7/21/2021

Recording: Risk Adjustment KPI Dashboards
Dean Ratzlaff, an actuary at Sentara Health Plans (Optima), is back for a deeper dive into the key performance indicator dashboards he and his team use. During our last session, Dean focused on dashboards and data used outside the department (like executives). During this session, Dean and his colleagues share the dashboards they use within the department during and after an intervention campaign and those used for provider engagement.

7/5/2021

Recording: Risk Adjustment Roundtable: July 2021
Connect with your Alliance risk adjustment peers to discuss your top challenges, share your expertise and build your network.

6/22/2021

Recording: Accreditation - The Pros and Cons of NCQA, URAC, COA
Join your Alliance peers for a deeper dive into this hot discussion forum topic that started May 11, 2021.

6/14/2021

Recording: Coding Work Group 2021, Session 3: IU Health Plan
Collaborate with your Alliance peers on risk adjustment coding best practices. During each session, you'll review a collection of recently coded medical charts provided by the health plan host, vote on how you would code each chart, then discuss the results as a group and share best practices. The remaining time is used for open discussion.

5/24/2021

Pre-Work Packet: Coding Work Group 2021, Session 3: IU Health Plan
Collaborate with your Alliance peers on risk adjustment coding best practices. During each session, you'll review a collection of recently coded medical charts provided by the health plan host, vote on how you would code each chart, then discuss the results as a group and share best practices. The remaining time is used for open discussion.