Risk Adjustment for EDS and RAPS User Group - August 17, 2017

Slide 7 - MOR, 2016 Updates
Slides 9-13 - RAPS Overview, RAPS Submission, Includes edit definitions and resolution strategies; Data Collection Year Diagnosis Codes
Slide 17 - Risk Score Calculation, EDS & RAPS Processing Flow
Slide 18 - Risk Score Calculation, Reports Used for Risk Scores and Payment
Slide 19 - Risk Score Calculation, Resource Guide
Slides 22-25 - Risk Score Comparison & Review, MMR, Includes data field descriptions
Slide 26 - Risk Score Comparison & Review, Medicaid Status Data Report (MSDR)
Slides 27-28 - Risk Score Comparison & Review, Hierarchical Condition Categories (HCCs) and MOR, Describes when to incorporate an HCC into the risk score
Slide 29 - Risk Score Calculation, Data Collection Periods and Payment
Slide 31 - CMS-HCC Risk Adjustment Model, Risk Segments
Slides 32-33 - Dual Status, Medicaid Status, Definition and Medicaid data sources
Slide 34 - Dual Status, Community ''Full Risk'' Risk Scores, Use of dual status
Slide 35 - Dual Status, Rolling anchor month reminder, Determining dual status
Slide 36 - Dual Status, New Enrollee Risk Scores
Slide 39 - Risk Adjustment Overpayment Reporting Module, Reporting Overpayment, Frequently Asked Question
Slide 40 - EDS Submission Overview, PY 2018 Submission Deadlines, Frequently Asked Question
Slide 41 - CPT/HCPCS Codes, Determining diagnoses for risk adjustment, Frequently Asked Question

Last Updated: 08/17/2017

Table of Contents