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Risk adjustment documentation & coding resource
June 23, 2021

This article is for providers caring for our Medicare Advantage members

Risk adjustment is a payment methodology used by the Centers for Medicare & Medicaid Services to ensure health plans are reimbursed appropriately for Medicare Advantage members.

We recently added a risk adjustment resource page to Provider Central. Log in and navigate to Quality & Performance>Quality Indicators>Risk Adjustment Documentation & Coding. The page covers:

  • What is risk adjustment?
  • Why is it important?
  • Remote submission
  • Telehealth
  • Coding tip flashcards on:
    • Chronic kidney disease
    • Deep vein thrombosis
    • Diabetes
    • Fracture
    • Major depressive disorder
    • Status codes
    • TAMPERTM
    • Unconfirmed diagnosis
    • Using active voice

We’ve also given you links to two fact sheets: Risk Adjustment and In-home care program with Signify HealthTM.

Questions on documentation and coding?

Send an email to the Risk Adjustment Coding Quality Education Team.

As always, thank you for the care you provide to our members.

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