Hi everyone. It’s Chandra here with CCO. Just wanted to give you a little update on what’s coming in our new RA 2.0 Course.
If you’re familiar at all with our risk adjustment course, you know that there are several modules included in our risk adjustment course as it currently exists. We have about 16. I have those listed for you on the screen.
Well, in the interest of streamlining our material what we did in Version 2.0 is we cut down on the number of chapters. We found that in Module 1 there were lots of chapters. It was really easy to get lost and some of the chapters were really, really small and some were very related to other chapters near them. So what we’ve done is, as I mentioned, we’ve streamlined. We’ve gone from 16 modules down to 7. It’s not that any of the material has been removed, actually quite the opposite. We’ve added a lot of new content.
We start out with an introductory module, giving you some of the information on the basics of risk adjustment, the history behind it, what else included in that. We then roll into risk adjustment models and talk about what plans are considered risk adjustment, how do they vary from carrier to carrier and payer type to payer type.
Then we get into coding for risk adjustment. This is by far the meatiest module that we have. And there’s a couple of asterisks next to it because there’s a lot of bonus material that we include in this particular piece of it. Because we know that the coding for risk adjustment is the key – that’s the key to getting the right payment, that’s the key to the correct documentation. All of those different pieces fall in there.
Then we have a module all about risk adjustment audits; what those look like, what’s the difference between a RADV audit and other types of audits, what’s a prospective versus a retrospective audit, what is concurrent review. We go through all of the different audit types as well as the important dates related to those audit types.
Then we get into documentation improvement and communication; how do you improve the existing documentation, what conversations you need to have with your physicians, and what’s the best way to communicate with your physicians. We keep in mind that most risk adjustment coders may or may not be working for a physician. There’s a lot of different roles that you play as a risk adjustment coder, and if you don’t have the ability to provide feedback to the physician, that can be a problem. If you’re working from the payer side of things, you have no communication with the physician. But if you’re working in a physician’s office or oftentimes if you’re working for a third party administrator, you may have access to the physician either in face to face conversations or through written queries. Both of those are key methods for communicating with your provider any documentation deficiencies that you may observe. We spend a lot of time talking about how to improve the documentation and educate your providers.
Then we start to talk a little bit about quality care impacts. Not just HEDIS and Star but there are a lot of other quality measures involved as well; things like Meaningful Use and OASIS and all of the different pieces that we see our coding affecting from a payment perspective.
In the last module we do something new. We bring all of this information together. We take everything that you’ve learned in the first 6 modules and give you a couple of case examples and show how they would change depending on which risk adjustment model they’re reported for and under. For example, risk adjustment coding for Medicare is not going to be exactly the same as risk adjustment coding for CDPS and some of the Medicaid-type carriers. It’s going to be different even still for the new ACA HHS risk adjustment models. So, we go through that. We show you how it’s going to change and what the different impacts are.
We’ve also included focusing on the key that the coding chapter is the meatiest chapter and that without proper coding and proper documentation, everything falls apart from a risk adjustment perspective. Keeping that in mind, we have gone back and looked at the pearls that we had before. If you were familiar with the pearls on our first module or if this is completely new to you, “what is a pearl?” is maybe a question you’re asking yourself. Pearls are little pearls, little gems of information that are really, really helpful. We’ve expanded those pearls. Before, the pearls were literally very, very small nuggets of information. We’ve taken pearls, we’ve expanded the number of conditions that we’ve developed pearls for and each of those pearls is now much more comprehensive. We define each condition for you. We talk about common symptoms, common manifestations, things that it can evolve into, proper coding and how to look up the codes for each of these conditions as well as if there is any Coding Clinic or relevant article information out there for advice on how to use these codes that may impact your code selection or the documentation needed. We’ve expanded this area tremendously. You’ll see before we had about 7 pearls. In the new program we have well over 25 pearls and we continue to add to those as the content goes on.
So we’ve really done a lot in this Version 2.0, increasing the amount of contents that’s there, streamlining it and making it a little easier to understand and giving you a lot more examples to practice with. So I hope that you’ll join us for Version 2.0 and check out our course. Happy coding!