June 8, 2017
Chart reviews can be useful in uncovering common documentation errors that impact both Medicare Advantage payments and potentially patient care. However, many healthcare organizations across the country are getting penalized by the Centers for Medicare and Medicaid Services (CMS) based on the medical record data they are submitting, due to inaccurate/missing HCCs or risk adjustment fraud. This means these providers and payers are seeing lower capitation adjustments and are losing out on millions in additional reimbursement payments every year. So, what do you think you will find if you have a secondary, contingent risk adjustment review on your patient population, prior to submitting to CMS?
The answer: Opportunity! With a secondary sweep, your chart review is more likely to result in the capture of missed data, leaving you with 100% validated results to then submit to CMS for your increase in payments and delivery of high-quality care. Combine the secondary sweep with a contingency agreement, and you are guaranteed a risk-free solution.
Unlike any other review process, MedKoder can provide you with a contingent review. If we do not find any errors after we review and validate your records, you receive a completely free review. If we do pinpoint and capture missed data, you will receive your secondary review and additional reimbursement payments from CMS. In both cases, you receive a risk-free review and financial peace of mind with your risk adjustment premiums. As the January 31, 2018 deadline approaches, now is the time for a secondary or even tertiary review of your 2016 medical records. What’s the risk? Contact us today for your secondary, contingent risk adjustment review!