SMG Risk Adjustment and New Provider Training

Review Hierarchical Condition Category (HCC) Value Based Risk Adjustment model(s) and why it is important Stronger understanding of the medical coding guidelines and regulations, including compliance and the impact of diagnosis coding Mindfulness to the auditing process for Center for Medicare and Medicaid Services (CMS) - HCC risk adjustment models and documenting and reporting chronic conditions yearly Awareness of “other” HCC Risk Models (Commercial, Medicaid (TENNCARE)) Realize the importance of a Risk Adjustment auditing process