CMS Best Practices Toolbox Snapshot

Toolbox Icon

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.

Magic Bullet Icon

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

Sandpaper Icon

Tool #4 – Sandpaper – Follow a provider abrasion checklist

Level Icon

Tool #5 – Level – Perform a data “balancing” by comparing ESPS and RAPS

Primer Icon

Tool #6 – Primer – Pay special attention to supplemental chart review data when “priming” it for CMS

Paint Chip Icon

Tool #7 – Paint Swatches – Test before production or the “paint brush”

Flashlight Icon

Tool #8 – Flashlight – Perform transactional monitoring to illuminate all systems involved in creating and submitting data

Nail Gun Icon

Tool #9 – Nail Gun – Nail gun vs. Hammer: Reduce paper claims burden and ensure maximization of EDI for inbound claims from providers

Information Guide Icon

Tool #10 – Instruction Guide – Take advantage of CMS documentation and user group calls

Measuring Tape Icon

Tool #11 – Measuring Tape – Determine how your submissions measure up

Drill Icon

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:

Tools icons