Online Training Course

Prod ID: 471
Welcome to Risk Adjustment

Risk adjustment, existing as early as 1977, has evolved more over the 21st century into the managed care payment model phenom. Different risk adjustment models which impact many care types and lines of business exist to serve the main purpose of ensuring proper payment on medical claims. They are supported by proper capture of each individual patient's complete healthcare picture through diagnosis and in some instances procedure code reporting.

CEUs

1

Length

47 min

Price

$119.00


Course Summary tab

This session is designed for learners who have a solid foundation of outpatient coding and wish to grow their knowledge about Risk Adjustment. Review medical coding guidelines and related regulations. Improve your understanding of reimbursement, diagnosis impact, risk tables, and mapping of code sets. Receive up-to-date instruction designed to increase your knowledge of the methodology behind HCC's. The history of risk adjustment, risk adjustment models, best practices for HCC coding, and payment programs are covered including:

  • Diagnosis Related Groups (DRG's)
  • Medicare Advantage Organizations (MAO's)
  • Program of All Inclusive Care for the Elderly (PACE)
  • HHS Hierarchical Condition Category (HHS-HCC)
  • CMS Hierarchical Condition Category (CMS-HCC)
  • Prescription Drug Hierarchical Condition Category (RxHCC)

Makema Massey

MHL, CMC, CPC, CRC, CPMA, CCS, RHIT, CPC-I

Makema Massey, MHL, CMC, CPC, CRC, CPMA, CCS, RHIT, CPC-I, is the Director of Account Management and Healthcare Coding at Sutherland Healthcare Solutions; and a Professor of Healthcare Informatics at American National University. Previously, she served as the Manager of Risk Coding at Optum. She has worked in medical coding and healthcare informatics for over 10 years and has a passion for paving the way for the future of healthcare and medical coding.

With medical coding as her core skill, she has built and executed thought-provoking leadership representation, healthcare, and coding insights, and helped many students reach their goals of obtaining a higher level of education through her lectures and motivating education style.  Massey's volunteer experience includes AHIMA PCAP: CEE Professional Certificate Approval Program Review Team, 2021-2023, Hillsborough Community College Advisory Review Board 2019-2020 as well as various charities.

Participants will improve their understanding of the methodology behind HCC coding and gain a historical reference
No prerequisites required but a foundation of outpatient coding will be beneficial.
Self-paced online program includes unlimited review of previously recorded instruction and the downloadable PowerPoint handout for 6 months.

Comments from past participants:

"Great information on HCC/Risk adjustments."

"Excellent; very informative!"

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