Third Pass: Risk Adjustment QA and Compliance
Compliance is an integral part of any risk adjustment strategy. The goal of capturing HCC codes is to accurately capture the full health status and disease burden of both individuals (and therefore populations) under value-based care. In this sense, the financial incentive is ultimately another tool CMS uses to motivate participants in risk-sharing arrangements towards […]
Risk Adjustment and Revenue Cycle: Benefits and Steps to Success
Risk adjustment and revenue cycle are becoming increasingly intertwined as more providers take on larger risk contracts under value-based care, shifting the mix away from traditional fee-for-service. Historically, risk adjustment has been dominated by retrospective reviews for the purposes of supplemental submissions. However, the same cashflow pressures that drive focus on revenue cycle performance are […]
Tag: Post-Encounter Worfklow
Discover how an NLP-enabled Workflow allows providers to capture risk factors following patient encounters.