HCC: Auditing in the Risk Adjustment Environment

Rose T. Dunn, MBA, RHIA, CPA, FACHE

$179.00

The essential information internal HCC auditors need to ensure their organization receives the reimbursement they are entitled to and that codes and claims are supported by clinical documentation. Learn what to look for and how to communicate your findings.  Tips and techniques offered by nationally recognized HCC authority Rose T. Dunn, MBA, RHIA, CPA, FACHE.

CEUs:     2 AHIMA      2 AAPC
Included in eLearning Library. Price per person. Group rates available.

The goal is revenue integrity.  Your task as an HCC auditor is to know what to look for, effectively communicate your findings, and proactively position your organization for success in the risk adjustment world.

Following the guidance in the “Medicare Managed Care Manual,”  HCC: Auditing in the Risk Adjustment Environment provides the essential information internal HCC auditors need to ensure their organization receives the reimbursement they are entitled to and that codes and claims are supported by clinical documentation.

  • The sources of guidance for Risk Adjustment Coding
  • Understanding what RAD-V and other external auditors are looking for
  • The role and responsibilities of the internal auditor
  • Creating policies and procedures to support accurate and complete HCC coding
  • Tips and techniques for conducting effective and productive HCC audits

Other Courses by Rose T. Dunn, MBA, RHIA, CPA, FACHE

HCC: Auditing in the Risk Adjustment Environment

Topic

Medical Record Reviewer Guidance
Dissection
Purpose
Federal Audit Requests
CMS Attestation
Auditor’s Role
Federal Auditor Reviews
Signature Issues
Transcribed Reports
EMR (Electronic Medical Record) Entries
Acceptable Documentation from Other Providers
Invalid Documentation
Skilled Nursing Documentation
Provider Type/Record Issues
Coding Guidelines
The Internal Auditor
Conducting the Audit
Addressing the Findings

  • WebinarPlus™ multimedia and interactive online course promotes engagement with challenging materials while offering independent self-study.
  • Knowledge checks and/or final assessment ensure mastery of material.
  • Online Flexibility! Materials available 24/7. Work at your own pace — save time and travel costs.
  • Earn Libman Education Certificate of Completion and CEUs.
  • To receive CEU credit, students must achieve a passing rate on the course assessment(s).
  • Course is self-paced. For planning purposes, assume 1-3 hours required for each CEU.
  • Unlimited course access during enrollment period. For courses offering greater than one CEU, enrollment period is 16 weeks. For courses offering one or fewer CEUs, enrollment period is 4 weeks. Courses purchased as a bundle or package may have a longer enrollment period.
  • Extensions to the enrollment period are available. Contact Libman Education for pricing.
  • Financing available through PayPal Credit.
  • Price listed is per person/per course. Group rates available upon request.

Special pricing available for groups. Train your entire team!

How Many In Your Group? Group Discount %
1 Retail Price
2-4 5% Discount
5-20 10% Discount
21+ Contact Us for Your Custom Price Quote:
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Rose T. Dunn, MBA, RHIA, CPA, FACHE

Rose Dunn is the Chief Operating Officer of First Class Solutions, Inc., a healthcare information management leader since 1988, offering professional consulting services in health information management operations and information governance issues, as well as coding support, coding quality reviews, privacy/security guidance, temporary (interim) management, revenue cycle oversight, and accreditation preparation. Rose jumped into the weeds of ICD-10 more than 10 years before it was implemented and has been getting back into the weeds of HCCs for the last 2 years. Rose is the author of Libman Education’s online course: Fundamentals of HCC Coding as well as “The Revenue Integrity Manager’s Guidebook” available from the National Association of Healthcare Revenue Integrity and other books on coding management and auditing. Ms. Dunn holds a B.S. and M.B.A. from Saint Louis University.

“I love this course, this is good for me and I am learning because my AAPC course didn’t cover half of this” — Melissa M.

“The quality of the courses that Libman presents is excellent” — Pamela S., RN, BSN, MSN, CCDS, Director, Clinical Documentation Improvement, Sharp Healthcare

“I tell everyone about Libman. I find that you have a very wide variety of choices in education that is actually needed and not so many things that aren’t really needed and can be mind boggling just trying to sift through it. Your website is well organized and everything offered is so well laid out and very informative as far as what you are getting, what I need and a very thorough write-up on everything offered. I’m so thrilled to have found your site!” — Sharon T

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“I truly thank you Libman Group for your wonderful courses that have contributed to my success.” — Leslie Jay Corn, CCS, CPC, CCA/ER Coding Analyst/Boston Medical Center OR LogixHealth

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“Libman has exceeded my expectations so far in every way, with the content of courses, but the hands on with the instructors is one of the best and most genius things to offer! All other companies I’ve seen in my 12 years in this field do not offer this invaluable service with their education. Answers to questions on education content is something that was desperately needed, but to my knowledge, it was/is not offered anywhere else and this is what sets Libman apart from the rest. Also, your high quality education and very knowledgeable instructors.” — coding student

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