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Resolving Compliance Issues with HCCs in a Risk-Adjusted Environment

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Working in a risk-adjusted environment while not knowing what to expect from external auditors and not having a mechanism in place to recognize that variations in documentation and coding practices may be occurring could trigger an audit.

Price: $229.00

Product Code: AR071719


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Description Biography
 

Physicians and those healthcare professionals working in Accountable Care Organizations (ACOs) realize that to be successful in a risk-adjusted environment, they must ensure that they provide quality healthcare that is affordable and comprehensive in order to achieve the maximum reimbursement to which they are entitled. To do so requires an understanding of the patient's acute and chronic conditions, while developing effective and efficient care plans that comply with a multitude of documentation and coding requirements.

This exclusive RACmonitor webcast will review the following issues:

  • How HCCs drive reimbursement
  • Important documentation requirements
  • What the hot spots are for external auditors
  • Preventive actions to ensure compliant practices

With Rose Dunn, you will explore some examples of issues and non-compliant practices that have surfaced and may arise in risk-adjusted environments. You will also benefit from discussions relative to preventative actions you can take to ensure compliant practices.

Why This is Relevant:

Hospital coding is one source of Hierarchical Condition Categories (HCC) for providers. This topic is equally, if not more relevant, to provider practices where the coding of most outpatient services will likely occur and where the compliance activities must originate.

Learning Objectives:

From this RACmonitor webcast, led by nationally-recognized HIM leader Rose Dunn, you will…

  • Understand the structure of HCCs and how the Risk Adjustment Factor (RAF) is calculated;
  • Learn how to recognize some of the inherent motivators to enhance reimbursement that may trigger compliance concerns;
  • Be able to discuss the documentation and coding requirements;
  • Understand the role and rules utilized by the Risk Adjustment Data Validation (RADV) auditors; and
  • Learn how to identify opportunities for routine compliance reviews in your organization

Who Should Attend:

Those who will gain most from this webcast are practice management, coding, compliance and CDI professionals.