This offering will be through PMI, not MCMS. Register through PMI directly - more details at link above!
Risk adjustment, existing as early as 1977, has evolved more over the 21st century into the managed care payment model phenom. Different risk adjustment models which impact many care types and lines of business exist to serve the main purpose of ensuring proper payment on medical claims. They are supported by proper capture of each individual patient's complete healthcare picture through diagnosis and in some instances procedure code reporting.
This session is designed for learners who have a solid foundation of outpatient coding and wish to grow their knowledge. Attend this session to learn about Risk Adjustment, review medical coding guidelines and related regulations, and understand reimbursement, diagnosis impact, risk tables, and mapping of code sets. The instructor will provide you with up-to-date instruction designed to increase your understanding and provide you with a greater understanding of the methodology behind HCC's.
This program will cover the history of risk adjustment, risk adjustment models, best practices for HCC coding, and payment programs to include:
- Diagnosis Related Groups (DRG's)
- Medicare Advantage Organizations (MAO's)
- Program of All Inclusive Care for the Elderly (PACE)
- HHS Hierarchical Condition Category (HHS-HCC)
- CMS Hierarchical Condition Category (CMS-HCC)
- Prescription Drug Hierarchical Condition Category (RxHCC)
- ICD-10-CM Risk Codes
Gain guidance for proper application of data quality, reliability, thus producing appropriate and timely reimbursement. Become best prepared for the future of healthcare reimbursement.
