tci Medicare Compliance & Reimbursement - 2022 Issue Q2

Foster Compliance With These 4 Risk Adjustment Steps

Know which provider types fall into the ‘acceptable’ category. If you’re interested in adding risk adjustment to your practice work plan, consider these four steps as you begin your program. Step 1: Verify that you meet the Centers for Medicare & Medicaid Services’ (CMS’) documentation requirements such as the following: Signature: Records must contain a valid provider signature and credentials. Date: Each face-to-face date of service (DOS) stands alone for outpatient reporting. Patient name: Record must be for the correct member/patient. Acceptable encounter: Acceptable services should be billed and processed. Step 2: Ensure you code all...

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