Risk Adjustment for EDS and RAPS User Group - April 19, 2018
Risk Adjustment for EDS and RAPS User Group - April 19, 2018
Table of Contents
- Slides 10-13 - MAO-004, Overview and comparison to MAO-004 Phase III, Summary of improvements and revised field descriptions; disallow reason code; Service Type
- Slides 14-17 - MAO-004, Accessing MAO-004
- Slide 17 - MAO-004, Inactive Contracts
- Slides 19-24 - MOR, Models, updates and record types, Which MOR reports will use new record types
- Slide 26 - CMS-HCC Risk Adjustment Model, Overview, Which models will be used
- Slides 28-34 - Risk Adjustment Model Overview, PY 19 Risk score calculation
- Slide 38 - MMR, Field 46 / Risk Adjustment Factor, Reasons why it may be null
- Slide 39 - Medicaid Status Data File, MMR, Why MMR and Status file may display different status
- Slide 40 - Chart Review Record Submissions, Primary diagnosis codes, Linked chart review need primary dx
- Slides 41-42 - MAO-004, Accessing MAO-004
- Slide 44 - Supplemental Services, Gym Memberships, Plans determine codes for supplemental services
Last Updated: 04/19/2018