Converting Risk Into Revenue CASE STUDY Jennifer Hill PC, CPMA, CRC Former AAPC Director of Client Engagement for Risk Adjustment RISK ADJUSTMENT CASE STUDY 2 Introduction The value of risk adjustment is drawing more and more attention at the organization and provider levels. What used to be primarily beneficial to health plans has been trickling down to participating providers in Medicare Advantage (MA), Medicaid plans, and other value-based contracts. This introduces new questions around auditing and compliance: • Is your documentation sufficient to support the risk adjustment hierarchical condition categories (HCCs) your organization is submitting? • Are your providers and coding staff capturing the correct laterality and specificity supported by the documentation? So

Join for free to read