Providers attend years of rigorous school, followed by multiple years of residency and fellowship programs in order to treat their patients to the highest quality of care and standards. While a provider’s training includes how to document the treatment of patients in the patient medical record, the training of coding documentation could be considered minimal - at best. This is no small concern, given that poor documentation standards could result in patient mismanagement, and a loss of revenue.
Of note, documentation is also used by health plans to process reimbursement payments to facilities and providers, and to assess the overall risk of their beneficiaries. They do this through a process called Risk Adjustment.
For some background, health plans are reimbursed for beneficiaries by validating chronic condition categories through their medical record documentation. Medicare Advantage Organizations (MAO’s) provide a combination of inpatient and outpatient services to their beneficiaries, which is also known as Medicare Part C. And that’s nothing to sneeze at, given that in 2019, MAO’s accounted for 34% of the 64 million people enrolled in Medicare.
Needless to say, medical record documentation should be clear, concise, and legible. This requirement not only validates conditions for MAO’s, but also simplifies the entire revenue cycle. But as many of you reading this will know, training providers on the importance of documentation can be a huge challenge. After all, their primary job is patient care, which is a huge job in-and-of-itself, and should never be discounted. But there are ways to effectively educate providers on the importance of documentation. Around here, it’s something we do for a living. During our time educating providers, we’ve learned a lot of great best practices that we love to share with our audience. Which is why on November 17, 2020, we’re hosting a brand new webinar, “How to Educate Providers on Risk Adjustment and Eliminate Documentation Gaps.” I’ll be joined by Charla Prillaman and Elizabeth Hylton, where during the course of the presentation, we’ll show you:
Why the Risk Adjustment Process is So Important
Where You May Have Documentation Gaps and Missed Revenue Opportunities
How Client Advisors are Improving Their Medical Record Documentation