RISKCON VIRTUAL

Tuesday, June 25, 9:00 AM - 10:00 AM, MT

GS1 / Final Rule Changes

TBA

Tuesday, June 25, 10:15 AM - 11:30 AM, MT

1A Track 1 / Risk Model Transition Overview – v24 to v28 / Khushwinder Singh, MD MHA, CPC, CPCO, CPMA, CRC; Sheri Poe Bernard, COC, CPC, CDEO, CRC, CPC-I

Participants in this session will learn the summary of the risk model shift, conditions most impacted, significant additions and deletions, examples of model differences, and how coding, auditing, and documentation improvement operations should prepare for the transition.

1B Track 2 / Overview of the OIG’s Recent Activities / Christopher Bresette, CPA

The Office of Inspector General (OIG) plays a crucial role in overseeing and ensuring the integrity of the Medicare Advantage program. This session will include discussions on some of OIG’s recent Medicare Advantage audits and tools that the OIG has published on how to improve compliance. Participants will learn who the OIG is (oversight of Medicare Advantage), how reviewing prior audit results and keeping track of the OIG work plan can help keep you compliant, and how using the OIG tool kit can also help with compliance.

Tuesday, June 25, 12:30 PM - 1:45 PM, MT

2A Track 1 / Health Equity and SDOH Capture / Dawn Carter, CPC, CPCO, CDEO, CPMA, CRC, Fellow

CMS is currently evaluating ways to incorporate social determinants of health (SDOH) into risk adjustment. In April 2023, CMS finalized the Health Equity Index (HEI) reward structure for the 2027 Star Rating to encourage Part C and D plans to improve care for beneficiaries with social risk factors. Learn about health equity and social determinants of health, how coders, auditors and documentation specialists have a role in capturing these social determinants, and how to prepare for this important evolution in risk adjustment data capture.

2B Track 2 / CDI Program Maturity Model

TBA

Tuesday, June 25, 2:15 PM - 3:30 PM, MT

3A Track 1 / AI Coding world & why coders are still needed / Kristen Viviano, MHA, CPC, CRC-I

As technology continues to rapidly advance, more and more solutions are making use of artificial intelligence (AI) to automate various processes. In this session, we will explore the pros and cons of diagnosis coding with AI and how coders can embrace the new technology.

3B Track 2 / Advanced Technology to Improve Risk Adjustment Programs / Melissa James, CPC, CPMA, CRC

Incorporating advanced AI technology into Medicare Advantage risk adjustment programs is the key to enhancing accuracy, efficiency, and overall effectiveness, ultimately leading to improved processes. This session will review the different types of AI that can be used to improve risk adjustment coding and why the human coder is an essential component to the overall success of risk adjustment programs.

Tuesday, June 25, 3:45 PM - 5:00 PM, MT 

4A Track 1 / Transition From Coder to Outpatient CDI / Ava Johnson, COC, CPC, CPCO, CPC-P, CDEO, CIC, CPB, CPMA, CPPM, CRC, CPC-I, CANPC, CASCC, CCC, CCVTC, CEDC, CEMC, CENTC, CFPC, CGIC, CGSC, CHONC, COBGC, COPC, COSC, CPCD, CPEDC, CRHC, CUC; Colleen Gianatasio, CPC, CPCO, CPC-P, CDEO, CPMA, CPPM, CRC, AAPC Approved Instructor

Join us for a lively, interactive discussion about the exciting new field of outpatient CDI and determine if this is the next step in your career. We’ll discuss where outpatient CDI is needed and cover the skills necessary to make the transition from coder to clinical documentation specialist.

4B Track 2 / Tips and Tricks to Survive a Regulatory Audit / Kimberly Rykaczewski, CPC, CRC

With increased scrutiny on Medicare Advantage plans, it’s now more important than ever to understand the impacts on the regulatory space. This session will review recent regulatory changes and how to prepare your risk adjustment compliance teams. We’ll discuss how advanced technology can support regulatory audits.

Wednesday, June 26, 9:00 AM - 10:15 AM, MT

GS2 / A Day in the Life of a Risk Adjustment Professional / PANEL / Barbara Shaw, CPC, CPCO, CDEO, CRC, CEDC; Jessica Diaz, CPC, CDEO, CPB, CRC, AHCCA; Melissa James, CPC, CPMA, CRC

We will discuss talking with industry experts for insights on the benefits of working as a risk adjustment professional, exploring the different roles and positions available in the risk adjustment space and discovering what education and experience employers are looking for to launch your career.

Wednesday, June 26, 10:30 AM - 11:45 AM, MT

5A Track 1 / A Day in the Life of a Diagnosis Code / Donna Malone, CPC, CRC, Approved Instructor

In this session, participants will learn how accurate diagnosis reporting impacts patient outcomes and learn to identify the many different areas that diagnosis codes impact including reimbursement, quality, and care management. 

5B Track 2 / All in a Day's (or Week's, or Month's or Year's) Work: Risk Adjustment Data Submission Requirements / Dawn Carter, CPC, CPCO, CDEO, CPMA, CRC

Most people who work in risk adjustment are aware that there are many requirements for data submission by Part C and D health plans, including many deadlines. Failure to meet these requirements creates risk adjustment compliance and payment accuracy issues for plans. In this session, you will learn about these deadlines and their significance, how plans can ensure that they meet these requirements, and the role of coders, auditors, and documentation specialists in supporting compliant submissions.

Wednesday, June 26, 12:00 PM - 1:00 PM, MT

GS3 / Networking Lunch

Wednesday, June 26, 1:15 PM - 2:30 PM, MT

6A Track 1 / Essentials of Compliance / Colleen Gianatasio, CPC, CPCO, CPC-P, CDEO, CPMA, CPPM, CRC, AAPC Approved Instructor

TBA

6B Track 2 / Strategies to Increase Coding Precision / Jeannine Bumford, CPC, CRC

Come learn effective strategies to increase coding precision. This session will focus on successfully building a risk adjustment coding team, best practices for implementing an NLP tool, and reviewing common coding errors.

Wednesday, June 26, 2:45 PM – 4:00 PM, MT

7A Track 1 / Understanding Risk Models Used today / Scott Weiner, CPC-A, CRC

Medicare Advantage, Medicaid Managed Care, and the Health Exchange all use different risk models to compensate payers. Learn more about the different models, how they work, and where they are used during this session.

7B Track 2 / Best Approach to Provider Engagement / April Boyce, CPC

This session will highlight best practices for enhancing provider engagement. We will discuss how provider organizations can identify physician leaders who are willing to adhere to vision and mission of the organization, how creating partnerships and keeping lines of communication open is vital to successful provider engagement. We will discuss the importance of coding education to physicians and how this provider education helps physicians understand our shared mission and goals, and we will discuss the how we support our providers by providing tools for success, and ongoing collaboration.