Transcription of Risk Adjustment Coding, HEDIS, and Documentation
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Risk Adjustment Coding, HEDIS, and Documentation
Risk Adjustment Coding, HEDIS, and Documentation Provider Education Training 4/10/2018. 2018. Objectives for Today Discuss the Risk Adjustment methodology Understand how complete and accurate Documentation and coding supports good patient care Tying in Quality and HEDIS measures Tips for accurate and complete Documentation and coding of common conditions Review Case Studies 2. Confidential and Proprietary Information What is Risk Adjustment ? Risk Adjustment is the mechanism by which government programs adjust the revenue to health plans based on the health status of the covered population (s). 3. Confidential and Proprietary Information Benefits of Risk Adjustment Optimizing Minimize Sufficient funding Quality and incentives Efficiency Disease Identifying management Special needs 4. Confidential and Proprietary Information Risk Score calculation Medical Record Review Hospital Claims Dx from Rx Claims Dx from Claims Provider Claims Supp.
•Risk Adjustment is the mechanism by which government programs adjust the revenue to health plans based on the health status of the covered population(s).
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