This is an overview on how to expand your Risk Adjustment renovation toolbox, so you can better construct and implement your data submission program. The following are the tools and strategies needed to implement the 12 CMS Best Practices and help ensure program success.
Tool #1 – Magic Bullet – Analyze transactional reports to track, prevent and resolve errors
Tool #2 – Highlighter – Review your report card with a highlighter
Tool #3 – Blueprint – Develop a blueprint for an integrated, high-quality process
Tool #4 – Sandpaper – Follow a provider abrasion checklist
Tool #5 – Level – Perform a data “balancing” by comparing ESPS and RAPS
Tool #6 – Primer – Pay special attention to supplemental chart review data when “priming” it for CMS
Tool #7 – Paint Swatches – Test before production or the “paint brush”
Tool #8 – Flashlight – Perform transactional monitoring to illuminate all systems involved in creating and submitting data
Tool #9 – Nail Gun – Nail gun vs. Hammer: Reduce paper claims burden and ensure maximization of EDI for inbound claims from providers
Tool #10 – Instruction Guide – Take advantage of CMS documentation and user group calls
Tool #11 – Measuring Tape – Determine how your submissions measure up
Tool #12 – Drill – Drill down into discrepancies and key analytics
*This is a synopsis of the Best Practice Toolbox series our Director of Product Strategy Dawn Carter developed. For more details, review her four articles and two webinars at: https://www.centaurihs.com/content-library/
