Tag Archives: assessment

Kaiser Permanente: Most Recent to Fall Under DOJ Scrutiny

Kaiser Permanente is the latest Medicare Advantage (MA) plan to be embroiled in allegations of False Claims Act violations for risk adjusted coding activities.  As you might recall, Humana was flagged for reporting unsupported risk adjusted diagnoses, Anthem allegedly failed … Read Full Post

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MRA Issues from the Trenches

We have blogged quite extensively on all things MRA and especially the need for solid documentation. Historically, a provider’s charting improves when the spotlight is shined on it, but old habits are hard to break; we find that, sadly, documentation … Read Full Post

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A Fundamental Disconnect of Risk Adjustment Documentation

When CMS launched the risk adjustment model for Medicare Advantage payments beginning in 2003, the reason for the change – in many minds – was shortened to, essentially, being paid more for sicker members.  While this is one part of … Read Full Post

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“Not-Assessments:” Misconceptions about Assessing Conditions

We educate a good bit about documentation of a proper assessment, use the acronyms M-E-A-T or T-E-A-M and still see skimpy notes with an “assessment” that doesn’t pass muster – from providers who, by now, should be on board with … Read Full Post

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