What is Risk Adjustment?

What is Risk Adjustment?

Risk adjustment is a newer payment methodology that is designed to allow for a proactive approach to managing healthcare. It does not seek to audit against current claims or encounters. It is a yearly collection of diagnosis codes to accurately build a total RAF (Risk...
The Importance of Getting Risk Adjustment Right

The Importance of Getting Risk Adjustment Right

Background Anyone who has taken the CRC™ (Certified Risk Adjustment Coder) curriculum can tell you that risk adjustment was first utilized in the mid-90’s for Medicaid purposes. The goal of risk adjustment has always been to collect data on patients so that money...

This Month in Healthcare

Healthcare is constantly in a state of transition, and it doesn’t take the summers off. July has seen several CMS announcements, innovations, and healthcare fraud busts. Hot off the digital presses, Advize has rounded up this month’s biggest stories so far. 2018-07-19...