Posts Tagged ‘coding compliance’
Where Are We With Sepsis? Read our latest report to find out.
By Brian Murphy Download the report here. Sepsis is deadly, prevalent, and expensive to treat, and therefore capturing it in documentation and coded data among the highest priorities of mid-revenue cycle professionals. It’s also one of the most difficult diagnoses to capture and the most at-risk, prone to denials and regulatory scrutiny. And there are…
Read MoreGrassley Report of UnitedHealth Group takes aim at these 20 diagnoses: Here’s why
By Brian Murphy The Grassley Report examining the risk adjustment practices of UnitedHealth Group (UHG) is much more than just a one-time media splash. The report is 105 pages long and contains a wealth of information and insight into how UHG does its work. This includes the criteria it uses to report diagnoses to…
Read MoreA very bad start to the year for Medicare Advantage; whistleblowers and government officials expose questionable risk adjustment coding practices
By Brian Murphy This has been a terrible start to the year for Medicare Advantage. Senator Chuck Grassley’s report “How UnitedHealth Group Puts the Risk in Medicare Advantage Risk Adjustment” landed like a bombshell on Jan. 12. It revealed the extent of UHG’s “robust diagnosis capture workforce,” from advanced analytics to in-home health assessments…
Read MoreSolutions Spotlight: OIG Toolkit a Valuable Blueprint for Risk Adjustment Coding Compliance
By Brian Murphy The OIG Toolkit To Help Decrease Improper Payments in Medicare Advantage Through the Identification of High-Risk Diagnosis Codes is a valuable tool in your compliance arsenal. One you should be using if you’re at all involved with risk adjustment. What is the Toolkit? The toolkit offers Medicare Advantage Organizations (MAO) information that…
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