Curriculum
From concept to application, you'll learn about the complexities of HCC coding, diagnoses codes and risk codes, the interplay of quality all the way through to revenue.
- Navigate the coding and documentation paradigm shift
- Master the mechanics of hierarchical coding
- Decode the inner-dependencies of HCC coding---diagnoses codes, risk scores and revenue
- Understanding the rules of engagement to evoke evidentiary data needed
- Sharpen your skills with RADV mock audit fire drills
- Distinguish how coding impacts the larger health plan organization from a financial context
- Demystify the fine line between coding and over coding
- Identify the common coding challenges and learn how to become a troubleshooter for your provider offices
Our six-hour online course covers the entire HCC coding landscape
Module 1: Why Do We Have Risk Adjustment? Introduction
- Define the purpose of Risk Adjustment in CMS payments
- Uncover health care program types that use Risk Adjustment for payments
Module 2: Risk Adjustment Overview for the Coder
- Review the CMS HCC timeline of payments
- Understand HCC categories and how to calculate your RAF score
- Learn how six disease interactions increase a RAF score
Module 3: Documentation and Coding for Risk Adjustment
- Understand the difference between coding history v. active conditions
- Recognize the most common guideline changes for 2017/18 ICD-10-CM
Module 4: Medical Record Requirements for Mock Audits
- Recognize the steps and identify criteria required for a mock audit
- Understand how to use mock audit results to reduce future risks
Module 5: Concurrent Workflows to Reduce Risk
- Understand strategic initiatives that can be implemented for improved reporting and provider support
- Review workflow processes in the healthplan and provider office to reduce risks of under-reporting & over-reporting
Module 6: HCC Coding-Coding Impacts
- Review case study examples to determine missed conditions and RADV risks
$700
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