Closing the HCC Gap: Capturing Correct Diagnoses for Improved Risk Adjustment
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This webinar will walk attendees through the basics of risk adjustment and the history of how and why we use risk adjustment. We will review some practical tools from everyday life that we use with our providers to alert them to potential diagnosis gaps as they are seeing and treating patients. And finally, we will look at different examples of documentation and evaluate the relative strengths or opportunities for improvement with a risk adjustment focus.
Why is this topic important?
Patients are moving to Medicare Advantage plans in larger numbers than ever before. Risk adjustment allows evaluation of the patient’s historical burden of illness and predicts future health care expenses. This ensures the commercial payers are receiving adequate funding from Medicare to cover the expenses of the enrolled patients.
Who would benefit from this topic?
Providers, billers, coders, auditors, documentation improvement and education staff, practice managers.
What information or new skills will the attendee take away from this webinar?
Ideas for how to approach providers to gather risk adjustment information. Examples of good documentation and ways to identify documentation improvement opportunities.
About The Author
Melissa Kirshner, CPC, CDEO, CRC, CPC-I
Melissa Kirshner, CPC, CRC, CPC-I, AAPC Fellow, is executive director of a physician organization in Southeast Michigan. She has more than 30 years of healthcare experience in billing, coding, compliance, education, and software development. As a certified PMCC instructor, she teaches billing and coding classes to prepare students for the CPC® exam. Kirshner is a founding member of the Novi, Mich., local chapter, and serves as treasurer.
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