Knowledge Center
Search Results: risk adjustment
When coders and providers work together, everyone wins. Risk adjustment coding is only as strong as the documentation it’s built on. Yet, in many organizations, coders and providers operate in silos. Providers are focused on delivering high-quality pa...
How to make the problem list an asset rather than a liability. According to the Centers for Medicare & Medicaid Services (CMS), risk adjustment allows Medicare Advantage (MA) plans to be paid based on the health risk of the patients they enroll, r...
Identify gaps, ask the right questions, and advocate for improved systems. Risk adjustment is a familiar concept for many medical coders, especially those working with Medicare Advantage (MA) plans, but Medicaid, which covers more than 70 million Amer...
Coders often find themselves walking on a tightrope. In the world of risk adjustment coding, professionals constantly find themselves walking on a tightropebetween accuracy and productivity. On one end lies the integrity of the medical record, and on t...
In AAPC News
Jul 1st, 2024
Comments Off on The Power and Profitability of Pre-Visit Risk Adjustment Reviews
Establishing a process for risk adjustment coding is a win-win for everyone involved. In a 2022 case study, AAPC Services found that most practices were either over- or under-coding diagnoses 14 percent of the time. The over-coding resulted in impro...