HCC Coding Tips: Documentation is Key

The premium that Centers for Medicare & Medicaid Services (CMS) compensates Medicare Advantage Plans is based on underlying health conditions of Medicare Advantage enrollees. These conditions are determined by a risk adjustment factor which is calculated using the enrollee’s age, sex, disability, Medicaid, and diagnosis codes. The conditions are identified through ICD-10 codes submitted [...]

By |2020-02-27T10:23:26-05:00February 18th, 2020|Providers|

Radiology Ordering Professionals: Know the AUC Program Requirements

The Protecting Access to Medicare Act (PAMA) requires the Centers for Medicare & Medicaid Services (CMS) to establish a program that promotes Appropriate Use Criteria (AUC) for advanced diagnostic imaging. AUC are evidence-based criteria that assist professionals who order and furnish certain imaging services to make the most appropriate treatment decisions for a specific [...]

By |2020-02-25T11:55:11-05:00November 12th, 2019|Providers|

How Family Practice of CentraState Benefits from CPC+

Family Practice of CentraState is now in its third year of Comprehensive Primary Care Plus (CPC+), which is a CMS Advanced Payment Model that aims to strengthen primary care through payment reform and care delivery transformation. This model provides additional financial resources and flexibility to help make investments, improve quality and access of care, and [...]

By |2020-02-25T11:54:30-05:00March 13th, 2019|Providers|
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