Author Archives: Rose Dunn

About Rose Dunn

Rose Dunn is the Chief Operating Officer at First Class Solutions, Inc., a healthcare information management leader since 1988. Rose is the author of “The Revenue Integrity Manager’s Guidebook” available from the National Association of Healthcare Revenue Integrity and other books on Coding Management and Auditing from HCPro. She engaged herself in ICD-10 more than 10 years before it was implemented. She is assisting Libman Education in the development of an HCC educational program. Rose holds a BS and MBA from Saint Louis University.
HCCs: Audits of Medicare Advantage Plans and a Coder’s Role

HCCs: Audits of Medicare Advantage Plans and a Coder’s Role

by Rose T. Dunn, MBA, RHIA, CPA, FACHE Hitting the headlines recently was the federal audit finding Humana overcharged Medicare nearly $200M. Humana Inc.’s Medicare Advantage health plan for seniors in Florida improperly collected nearly $200 million in 2015 by overstating how sick some patients were. The audit of Humana occurred from February 2017 to […]

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HCCs: 7 Steps Medicare Advantage Organizations Should Take Now to Capture Members’ Risk Scores

HCCs: 7 Steps Medicare Advantage Organizations Should Take Now to Capture Members’ Risk Scores

by Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA The pandemic has affected every sector and population category across the US (and the world). Some business sectors thrived (Amazon, pizza delivery services, plexiglass manufacturers, and mask producers to name a few), but as we know, the healthcare industry took a big hit. When I say […]

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Hierarchical Condition Categories: The Roles and Responsibilities of the Internal Auditor

Hear Rose T. Dunn, MBA, RHIA, CPA, FACHE, a nationally recognized HCC expert, provide a free, brief presentation: “Hierarchical Condition Categories:  The Roles and Responsibilities of the Internal Auditor.”   HCC: Auditing in the Risk Adjustment Environment The essential information internal HCC auditors need to ensure their organization receives the reimbursement they are entitled to […]

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Hierarchical Condition Categories: Auditing in the Risk Adjustment Environment: The Auditor’s Role

Hear Rose T. Dunn, MBA, RHIA, CPA, FACHE, a nationally recognized HCC expert, provide a free, brief presentation: “Hierarchical Condition Categories: Auditing in the Risk Adjustment Environment: The Auditor’s Role.”   HCC: Auditing in the Risk Adjustment Environment The essential information internal HCC auditors need to ensure their organization receives the reimbursement they are entitled […]

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