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Medicare Advantage Risk Adjustment
Find All Lost Revenue . . . Defensibly
While Training Your Physicians . . . Concurrently
We're Better Don't rely on programs that only pick "the low hanging fruit". This leaves enormous lost revenue and also puts you at risk for overcode repayment. |
RA/HCC Triad
Reviewing all patients' medical records to find lost revenue.
Making sure you have defensible documentation.
Training your physicians.
In addition to the revenue enhancement offerings that have been promoted by many vendors, defensibility of these processes and methodologies is now in question. "Suspect lists" and "data snooping" can certainly help find the low hanging fruit of missed HCC codes and revenue... but, until plans have a defensible level of accuracy, only 100% review of patient charts by qualified experts and physicians can fully protect a risk plan or provider from the effect of an audit . . . by ensuring that ALL patient charts are properly coded and fully documented.
Luckily, because of poor documentation, and lack of understanding the process, undercodes prevail! That is, so far, ALL of our clients have experienced a substantial net increase - better still - they become fully compliant with CMS.
MARSI’s 15 years of experience in defensible and accurate ICD-9/DRG coding assignment, and our more recent experience in the similar RA/HCC model has again found . . . read more
Be CautiousObvious undercodes are just somewhat greater than overcodes. . . but your ROI can be substantial if we identify and resolve ALL documentation concerns. This requires a thorough query process.
The Query Process . . .The query process generates enormous revenues. . . in most cases. Read more about the query process