This live course is designed for Rural Health Clinic (RHC) providers, quality managers, ACO leadership, and revenue cycle staff at rural health facilities who need a high-level basic explanation of how to report accurate quality metrics and who deal with HEDIS, HCC, QIP, Risk Adjustment, and Share Savings.
RHC Overview: We will begin with a RHC documentation>coding>billing overview including:
Reporting Quality: After a brief overview of HEDIS/HCC and other Quality Improvement programs, we will dive into relevant sections of the ICD-10-CM's "Official Guidelines for Coding & Reimbursement" and will review the instructional notes associated with key diagnoses in order to most accurately report the true complexity of care for your ACO patients and to:
1 - Attendees will be able to unify their clinical documentation goals with the requirements of Managed Care/ACO's to adjust payments based on clinical complexity of its patient population.
2 - Attendees will learn about the specific documentation guidelines and base code instructional notes associated with the major disease categories being tracked by ACOs.
3 - Attendees will learn a structure by which they can train their providers on those additional codes and HCC categories that may become a focus in the future and how their EHRs may hinder effective training.
The following groups will benefit from class: