Tag Archives: risk adjusted reimbursement

Wanna Bet Not All Your MDDs Are Valid?

Major Depressive Disorder (MDD) is fast becoming one of the most poorly supported conditions we find during audits, and it may stem from the fuzzily documented distinction between depression and major depression.  After all, not all depression fits in the … Read Full Post

Tagged , , , , , , |

Telehealth & MRA

There is much miscommunication regarding the use of telehealth services to report risk adjusted diagnoses.  In the early days of COVID-19, CMS stated that it would pay for telehealth services that were conducted in an interactive format using both audio … Read Full Post

Tagged , , , , |

Coding Cancers: A Common Charting Error

One of the most common provider charting errors occurs in the area of cancer diagnoses.  Practitioners routinely document and code cancers when the patient’s disease has been treated and is no longer evident.  For risk adjusted practices, this means the … Read Full Post

Tagged , , , , , , , , |

Maximizing the first patient visit of a period

Risk adjusted reimbursement hinges on proper management and reporting of a patient’s chronic conditions.  We always advise clients to assess all chronic conditions at least twice per year: once in the period between January 1st and June 30th and again … Read Full Post

Tagged , , , , , , , , , , |

Medicare ACOs: Risk Adjusted Reimbursement’s Mathematical Impossibility (Part 5)

So far in this five-part series on Medicare ACOs, we’ve explored the basics of the concept, the patients’ participation, the fundamentals of reimbursement as well as the provider’s role and incentives.  Recall that we explained in an earlier section that … Read Full Post

Tagged , , , , , , |