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Medicare Advantage Risk Adjustment
Find 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 patients' medical records to find lost revenue.
A true compliance program identifies and corrects for overcodes and undercodes that result in over reporting and under reporting. Obviously, they result in underpayment or risk of future repayment. "Data Snooping" or "Suspect Lists" will not identify both types of errors equally. In fact, they usually look for "upside" only, leaving organizations exposed to liability of repayment or worse yet, accusations of intentional abuse or fraud.
Only a thorough chart audit process can discover both undercodes and overcodes as well as other errors. That's what MARSI has done for over 15 years.
The Good News 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 plus 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
Obvious undercodes are usually just somewhat greater than overcodes — but your ROI can be substantial if we identify and resolve ALL documentation concerns identified through the audit process. This requires a thorough query process.
MARSI's Unique Query ProcessIn most cases the query process generates enormous revenues.