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  • Medicare Advantage Hierarchical Condition Categories: Targeting Chart Reviews
    Medicare Advantage Hierarchical Condition Categories: Targeting Chart Reviews Identifying and submitting all appropriate ICD-9 diagnosis codes to CMS will result in a higher risk score for the ...

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    • Authors: Corey Berger, Eric P Goetsch
    • Date: Jan 2011
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving
    • Publication Name: Health Watch
    • Topics: Demography; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining; Social Insurance>Medicare; Technology & Applications>Analytics and informatics
  • Medicare Advantage experience data: pitfalls and concerns beyond ASOP #23
    Medicare Advantage experience data: pitfalls and concerns beyond ASOP #23 Medicare Advantage Organizations must consider influences both internal and external to the adjudication process as they ...

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    • Authors: Michelle Wahab, Shelby Weber
    • Date: Mar 2019
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health information technology; Social Insurance>Medicare; Technology & Applications>Data warehousing