Risk Adjustment/Coding Toolkit
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Presentation: Risk Adjustment Comparative Overview
As part of the Risk Adjustment & Quality Learning Collaborative, Pat Petty provides a comparative look at the different risk adjustment models in the Medicare Advantage, ACA, and Medicaid space.
Recording: Documentation and Coding: Best Practices for Chronic Conditions
CMS has instructed that only ‘active’ conditions should be reported via a claim for risk adjustment. As part of the Risk Adjustment & Quality Learning Collaborative, Pat Petty with Gorman Health Group discusses what documentation elements are required to substantiate a chronic diagnosis through a Risk Adjustment Data Validation audit.
Presentation: Documentation and Coding: Best Practices for Chronic Conditions
CMS has instructed that only active conditions should be reported via a claim for risk adjustment. As part of the Risk Adjustment & Quality Learning Collaborative, Pat Petty with Gorman Health Group discusses what documentation elements are required to substantiate a chronic diagnosis through a Risk Adjustment Data Validation audit.
Recording: Navigating Risk-Adjustable Chronic Conditions: The Ultimate Course for the PCP
This session is one in a series focused on delivering educational risk adjustment coding content. The topic of this session hasn’t been set yet, but will focus on assisting coders in making appropriate decisions when it comes to coding particularly challenging documentation, provide updates on new diagnostic codes and HCC model updates, or discuss documentation that was accepted or not accepted by CMS.
Presentation: Navigating Risk-Adjustable Chronic Conditions: The Ultimate Course for the PCP
This session is one in a series focused on delivering educational risk adjustment coding content. The topic of this session hasn�t been set yet, but will focus on assisting coders in making appropriate decisions when it comes to coding particularly challenging documentation, provide updates on new diagnostic codes and HCC model updates, or discuss documentation that was accepted or not accepted by CMS.
Acceptable Physician Specialty Types for 2020 PY
CMS provides a comprehensive list of specialists that are approved for risk adjustment for 2020.
Recording: Natural Language Processing: Impact on Coding_Change Healthcare
Change Healthcare explains the impact of the Natural Language Processing (NLP) on code operations, such as code assignment, process, productivity, compliance and financial impact.
Presentation: Natural Language Processing_Change Healthcare
Change Healthcare explains the impact of the Natural Language Processing (NLP) on code operations, such as code assignment, process, productivity, compliance and financial impact.
Recording: Coding Work Group Session 6: MediGold
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.
Chat Transcript: Coding Work Group 2020, Session 6: MediGold
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.
Presentation: The New Medicare HCC Model V24 (Earn 1 CEU)
As part of the Risk Adjustment & Quality Learning Collaborative, Change Healthcare discusses the new HCC model, version 24, as updated by CMS.
Recording: The New Medicare HCC Model V24 (Earn 1 CEU)
As part of the Risk Adjustment & Quality Learning Collaborative, Change Healthcare discusses the new HCC model, version 24, as updated by CMS.
Recording: Risk Adjustment Round Table 2020, Session 6: Using AWS for Edge Server Submissions
Wesley Sanders, Vice President, Finance and Analytics at Alliant Health Plans shares step-by-step instructions, best practices, and detials on his experience working with the CMS EDGE support team while moving your Edge Server submissions in-house.
Case Studies: Coding Work Group 2020, Session 6 - MediGold
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.
Recording: Changes to ICD-1-CM Codes & Guidelines
Change Healthcare team provides the most current (2021) updates regarding ICD-10-CM Official Coding Guidelines for Coding and Reporting FY 2021. Attendees review ICD-10-CM updates from the Centers for Medicare & Medicaid Services (CMS) effective October 1, 2020.
Chat Transcript: Coding Work Group 2020, Session 5: 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.
Recording: Coding Work Group 2020, Session 5: 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.
Recording: Risk Adjustment Round Table 2020, Session 5: Shifting strategies during COVID-19
COVID-19 has completely disrupted our 2020 risk adjustment strategies. How have health plans pivoted? What does your in-home health assessment program look like now? What new things are you trying to ensure you capture a current picture of your members' health for 2020? Join us to share your plan's experience and hear from others.
Case Studies: Coding Work Group October 2020, 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.
Recording: Coding Work Group 2020, Session 4: CHRISTUS 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. Remaining time is used for open discussion.