Tag Archives: risk score

Pitfalls in Chart Reviews: It’s not only about the Bottom Line

In this last blog in our four-part series on pitfalls, we thought we’d discuss the culture of your MRA department and how it guides the work.  Our almost-20 years in this field have brought us into contact with practices and … Read Full Post

Tagged , , , , |

What We’re Reading – DOJ Launches Lawsuit Against Anthem for Risk Adjustment Fraud

As detailed in this article, Anthem is facing a lawsuit initiated by the Department of Justice (DOJ) for allegedly failing to remove erroneously submitted diagnoses from CMS’s database despite knowing that inconsistencies might be present. The health insurance carrier commissioned … Read Full Post

Tagged , , , , , , , , |

Why is my Risk Score so low when my patients are so sick?

A risk score is a numeric representation of the health status of your patients based on factors developed by the Centers for Medicare and Medicaid Services (CMS). Each patient has a risk score and your practice has one too. The … Read Full Post

Tagged , , , , , , , |