RCM tip of the day: Develop a risk adjustment strategy

As healthcare organizations look to improve Medicare Advantage reimbursements, they should ensure risk adjustment and Hierarchical Condition Category coding is done properly, according to Nancy Lopez, a revenue cycle manager for the lost revenue recovery program at BillingParadise.

Ms. Lopez shared the following tip with Becker's Hospital Review.

"Hospitals confront tough challenges in delivering better health outcomes with lower medical costs while maintaining CMS regulatory compliance and optimizing revenue. [Therefore], planning a competent risk adjustment strategy and deploying right population health management systems with some professional advice becomes imperative. This helps to automate workflow and data sharing, manage compliance, optimize revenue with accurate HCC codes and improve [Overall Hospital Quality] Star Ratings altogether."

If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series. 

 

 

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