By Laurie L. Prescott, MSN, RN, CCDS, CDIP, CRC, and Sharme Brodie, RN, CCDS
The goal of the risk-adjustment model applied to Medicare Advantage plans is for Medicare to provide more accurate payments to the plan administrators to compensate for the care provided.Read More »
By Laurie L. Prescott, MSN, RN, CCDS, CDIP, CRC, and Sharme Brodie, RN, CCDS
There are a number of risk-adjustment models used in healthcare which affect reimbursement as well as quality of care reporting metrics. Each model has its own nuances, but all employ ICD-10-CM diagnosis...Read More »
eClinicalWorks, a leading EHR vendor, has been sued for nearly $1 billion over allegations that its software’s patient data are not accurate and reliable.Read More »
Q: We are trying to educate our coding department about medical necessity, but has CMS or Medicare defined it anywhere? How can we explain it to staff?Read More »
