ArroHealth is a premier national provider of technology-enabled, end-to-end services that help health plans and provider organizations assess and impact their risk adjustment and HEDIS programs. Health plans and provider groups focused on Medicare Advantage, managed Medicaid, Commercial populations and those participating in the commercial exchange marketplace use our solutions to ensure accurate reimbursement, improve the quality of care, and manage health care costs.
By RaeAnn Grossman What does your risk adjustment team need to think about from application time to bid season? Answers include but are not limited to: Are we changing our formulary and will this impact Rx risk adjustment? Are we narrowing our provider networks and will this impact campaigns or waves? Are we capitating more […]
By RaeAnn Grossman First, have you integrated compliance and risk adjustment? Have you embedded your risk mitigation strategies? Here are a few items that should be on your compliance for risk adjustment checklist: Review coding guidelines quarterly (internally and with vendors) Perform 2LR and 3LR annually Embed claims validation into Medicare Advantage, Commercial, and Medicaid […]