3427 Medicaid and Medicare Compliance

Location: Phoenix, AZ
Date Posted: 12-05-2017
Assists providers in understanding the Medicare Stars quality program as well as CMS -HCC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedures and diagnosis coding 

Utilizes analytics and identifies and targets providers 

Monitors Stars quality performance data for providers and promotes improved healthcare outcomes 

Utilizes analytics and identifies and target providers for Medicare Risk Adjustment training and documentation/coding resources 

Assist providers in understanding the Medicare Stars quality and CMS -HCC Risk Adjustment driven payment methodology and the importance of proper chart documentation of procedures and diagnosis coding 

Supports the providers by ensuring documentation supports the submission of relevant ICD -10 codes and CPT2 procedural information in accordance with national coding guidelines and appropriate reimbursement requirements 

Routinely consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes 

Ensures member encounter data (services and disease conditions) is being accurately documented and relevant procedural codes and all relevant diagnosis codes are captured 

Provides thorough, timely and accurate consultation on ICD-10 and/or CPT 2 codes by providers or practice clinical consultants 

Thanks & Regards
Deepa
Reqroute
Cell:602-625-3427
email: deepa@reqroute.com

 
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