Transcription of Medicare Advantage Risk Adjustment Data Validation …
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Medicare Advantage Risk Adjustment data Validation (RADV) TrainingContract-Level Industry-Wide Training EventJanuary 29, 20191:00 2:30 , ET Welcome and IntroductionsCenter for Program Integrity (CPI) Alec Alexander Center DirectorGeorge Mills, Jr., Deputy DirectorJonathan Smith Program Manager (RADV Team)RADV Team Members Joanne Davis Larry Johnson Brenda M. JohnsonEsmail Essajee Evan Boyarsky Melissa Cooley Melissa HeestersGulnurFreemanDelois Newkirk Beth Schalm Mary B. Walker Martha Wagley2 Agenda Highlights3 Contract-Level RADV TerminologyTe r mDefinitionCYCalendarYe a rCON14 RADVCY 2014 Contract-Level RADVCMSC enters for Medicare & Medicaid ServicesC DATC entral data Abstraction ToolHCCH ierarchicalCondition CategoryINVI nvalid4Te r mDefinitionICD-9-CMInternational Classification of Diseases, N
Jan 29, 2019 · • The Part C CMS-HCC model is used to pay MAO plans for non-End Stage Renal Disease (ESRD) enrollees (with 12 months of Medicare Part B coverage during the data reporting period [i.e., full risk beneficiaries]). • There are three (3) possible scores produced by the model: – Community: Based on enrollees with less than 90 days in an ...
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