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Medicare Risk Adjustment

 

Risk adjustment is a process that the Centers for Medicare & Medicaid Services (CMS) uses to reimburse Medicare Advantage (MA) plans based on the health status of members. Risk adjustment ensures that CMS pays plans appropriately for members’ predicted health costs based on demographics (age and gender) and health status (claims data).

 

 

General Information

 

 

General Coding and Documentation Tips

 

 

Coding Reference Guides

 

 

Commonly Coded Diagnosis

 

 

Reference Guides by Condition - Provider Documentation and Coder Abstraction

 

 

Clinical Documentation Tips - By Specialty

 

Training Webinars

 

 

Questions? Need more information?

Email us at the following address: MedicareRiskAdj@hmsa.com

 

 

 

First Published:08/09/2017
Latest Revision:06/13/2018
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