Advanced HCC Coding & Documentation 2016

Key Topics

• Putting in place a provider education program: make or buy? In-source or outsource?
• Clinical documentation improvement program best practices: critical success factors, key metrics tracking and reporting, using mock audits, etc
• Payer-agnostic versus payer-centric considerations: universal applicability versus specific improvement or preparation initiative
• Prioritization and stratification of provider network for optimal training results, along with scoring techniques and use of metrics
• Assessment and identification of systemic errors, sources and stratified targeting
• Disconnects between RAF score impact on plan payments versus clinicians paid on RVU basis
• Tools for cycle management and take-home plans for implementation strategies
• Developing corrective actions and improvement initiatives
• Consider the provider office workflow: who is involved at each step?
• Keeping it all straight: RADV, routine CMS chart audits, HHX chart audits, HEDIS chart audits, etc
• On-boarding new employees in every role involved
• How to you build a training program from scratch and implement for each target audience
• Addressing practices still using paper charts versus surfacing EMR-related issues and stumbling blocks
• Approaching provider practices depending upon size (small, medium and large)

Who should Attend

Health plan and provider group leaders, consultants and service providers with responsibilities in:

• Managers or directors of the HCC coding, quality and education functions
• Risk adjustment leadership in Medicare Advantage or ACA marketplace plans
• Compliance, legal & quality audit program managers
• Clinical Documentation Improvement (CDI) managers
• ACOs with MSSP, Pioneer or Next Gen Medicare ACO contracts, or with commercial risk adjusted ACO contracts
• Coding and documentation management with at-risk provider groups