SMG Risk Adjustment 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