Posts Tagged ‘coding compliance’
A 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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