Tag Archives: chart review

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

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Pitfalls in Chart Reviews: Specialist Notes

In this four-part series, we’ve explored so far, the use of suspect reports and issues related to prior medical records.  In this installment, we’ll look at what can make specialist notes a little challenging to the chart reviewer. Although the … Read Full Post

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Pitfalls in Chart Reviews: Prior PCP Records

In Part 2 of this series on the challenges encountered in chart reviewing for risk adjusted conditions, we’ll discuss the prior PCP.  Every single primary care practice has a mechanism for requesting and obtaining records from the patient’s prior primary … Read Full Post

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Pitfalls in Chart Reviews: Suspect Reports

Our company began working with risk adjusted payments in 2004, shortly after the CMS-HCC model was implemented, and as you can imagine, we’ve reviewed thousands of medical charts.  Over the years, as providers from all specialties have become more versed … Read Full Post

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Some MA Companies Used Questionable Means to Drive MRA Payments

The Office of Inspector General (OIG) audits Medicare Advantage plans for, among other reasons, to assure they submit accurate and true information to the Centers for Medicare and Medicaid Services (CMS) and thereby, receive proper risk adjusted payments.  The OIG’s … Read Full Post

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