Tapping into EHR data for public health surveillance could streamline reporting, facilitating more complete and timely data collection and the use of eCQMs showed promise for improving clinical data analysis and reporting, according to the agency.
This hunt for patient perspective, which is becoming more and more common, is fueled in part by the health law's quality-improvement provisions and other federal financial incentives, such as the link between Medicare payments and patient satisfaction scores.
Medicare Advantage (MA) plans are private health plans that have contracted with Medicare to receive a fixed monthly fee in exchange for providing comprehensive healthcare to plan members. In order to provide appropriate care to beneficiaries with varying medical conditions, plans are paid according to the Risk Adjustment Factor (RAF) score of each patient. Insufficient documentation of chronic conditions can be an obstacle to MA reimbursement. However, even when a condition has been properly documented by the provider, it is often not coded and submitted to Medicare. Read this white paper to learn how to take the complexity out of MA reimbursement.
Coders can be hired as employees or freelancers, which means planning and budgeting now. And medical practices need to do a cost-benefit analysis to determine if it's better to hire personnel or accept longer reimbursement cycles.