Act now to score positive payment adjustments under MIPS. This year, the Cost performance category in the Merit-based Incentive Program (MIPS) is worth 10 percent of an eligible clinician’s or group’s final score. Next year, it goes up to 15 percent — and Cost will continue to gain weight until it accounts for 30 percent ...
The Centers for Medicare and Medicaid Services (CMS) released a Final Rule freeing more than $10.4 billion to anxious payers to continue the Affordable Care Act’s (ACA) risk adjustment program. The agency had halted payments to payers while a New Mexico ruling was challenged, but in the end the activity unnerved the industry and didn’t change much. Risk Adjustment ...
As a Certified Risk Adjustment Coder (CRC™), you’re an advocate for payers, providers, and patients. By Richard “Rik” Salomon, CPC, CRC HCC (hierarchical condition category) coding affects payers, providers, and patients in every setting. But capturing HCC codes in the emergency department (ED) is complicated because of the urgency to process patients quickly. Primary care ...
Train radiologists and physicians to work together to capture this deadly disease in the medical record. By Mary E. Wood, CPC, CPC-I There are certain hierarchical condition categories (HCCs) that specialists feel comfortable capturing, which include hypertension, diabetes, and chronic kidney disease. The manifestations of all three of these diseases find their way into multiple ...
In CMS
Apr 13th, 2018
The Centers for Medicare & Medicaid Services (CMS) put on display April 9 a rule that finalizes several proposed changes that will significantly expand the role of states in the administration of the Patient Protection and Affordable Care Act (PPACA), with the intention to reduce regulatory burden and increase flexibility. Background of the PPACA President Obama ...