FRIDAY July 31, 2015:
Dealing with
Medicare Advantage Plans
Best Practices, Risk Adjustment and
What should your attitude be?
Risk is a consequence of action taken in spite of uncertainty – a potential, unpredictable, unmeasurable and uncontrollable outcome. Hence, the use of so-called “Risk Adjustment” data as a way to calculate payment for care of a beneficiary of a Medicare Advantage Plan.
Ok, picking up where we left of last week, we are planning to have Sharon Easterling available to go over some highlights from a recent talk she did for her clients about dealing with Medicare Advantage plans and Risk Adjustment – including how she advises you to handle all those documentation requests that some of you have been seeing in droves, lately.
Sharon Easterling and others will review and discuss with us:
- What MA Plan requests mean,
- How to handle those requests,
- What you should think about it, and
- WHY you should think that way.
I’m thinking that this picture most accurately reflects how CMS is feeling, or at least this is perhaps the way that the OIG is making them look. At least, for once, providers are not the ones under fire. So far.
Sharon will also be telling us about an article and talk she is doing for AHIMA on the role of data and risk adjustment, plus how providers need to pay more attention to the Ambulatory side of the street, because CMS is heading there!
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William Malm, ND, RN, CMAS, CRCR – Practicing Clinician and Certified Medical Auditor
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