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HCCs: Impact on Quality

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HCCs: Impact on Quality

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

$59.00

Author Rose Dunn, MBA, RHIA, CPA, FACHE, a nationally recognized authority in HCC and risk adjustment coding methodologies, explores the intent and purpose of various Medicare quality programs focusing on the importance of accurate, “by-the-book”, complete, and defensible coding and documentation.

CEUs:  1    1 AHIMA    1 AAPC
Included in eLearning Library. Price per person. Group rates available.

Overview

HCC codes are used to adjust Medicare payments to insurers, providers, and health systems based on differences in expected spending. The accuracy and completeness of the codes being reported can lead to bonuses (or penalties!) for providers.

Author Rose Dunn, MBA, RHIA, CPA, FACHE, a nationally recognized authority in HCC and risk adjustment coding methodologies, explores the intent and purpose of various Medicare quality programs focusing on the importance of accurate, “by-the-book,” complete, and defensible coding and documentation.

HCCs: Impact on Quality provides:

  • An historical and current review of the intent and challenge of various Medicare quality programs
  • Learn why complete and accurate documentation is vital to proper reimbursement for HCC services
  • Accurate documentation leads to accurate codes which leads to accurate payment and quality scoring. Examples given to demonstrate the payment effect of missing or incomplete documentation.

HCCs: Impact on Quality Syllabus

  • Brief overview of HCCs
  • Demand for Quality
  • Provider Response
  • Government Quality Initiatives
  • Value Modifier Program
  • Bundled Payment Program
  • Quality Payment Program
  • Merit-Based Incentive Payment System
  • Advanced Alternative Payment Models
  • Hospital Value Based Purchasing Program
  • Healthcare Effectiveness Data and Information Set (HEDIS)
  • Relationship Between Coding and Quality
  • Risk Adjustment Factor (RAF)
  • Quality Scoring
  • Star and Quality Ratings
  • Bonuses and Medical Loss Ratio

The level of effort to complete this course, start to finish, is equivalent to 1 CEU and should take you approximately 1-3 hours to complete. Remember: You have access to the course materials for the full 4-week enrollment period and we encourage you to re-review any materials that are helpful to you.

Certificate of Completion
Upon successful completion of the course work, student will be able to download a Libman Education Certificate of Completion. The Certificate of Completion will list the course as awarding 1 CEU.

AHIMA: 1 CEU
This program has been approved for continuing education unit(s) (CEUs) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting of Approved CEUs from AHIMA does not constitute endorsement of the program content or its program provider.

AAPC: 1 CEU
This program has the prior approval of AAPC for continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

  • WebinarPlus™ multimedia and interactive online course promotes engagement with challenging materials while offering independent self-study.
  • Teaching methods including audio and video files, diagrams, and animations to accommodate different learning styles. Where appropriate, the Merck Manual Professional Version supplements course materials with in-depth descriptions of diagnoses and/or procedures.
  • Knowledge checks and/or final assessment ensure mastery of material.
  • Online Flexibility! Materials available via secure Learning Management System (LMS). 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.
  • Price listed is per person/per course. Group rates available upon request.

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.

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