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Compliance, the biggest challenge to a medical practice today, can also be its greatest opportunity. It can be the biggest danger and also the most significant firewall of protection. The new provider coming out of school does not have the knowledge included in this book. Many providers who have been in business for years don’t realize the shark-infested waters they swim in. Compliance Made Simple was written as a compendium of those things that might not ever occur to a medical provider at any level who is either going into practice with a group or attempting to go it solo.
Whether you are a doctor or a mid-level provider of medical care in the managed care arena, whether you have experience with managed care or are new to it, Medicare Risk Adjustment is a funding system and a critical patient risk identifier to your success both today and for the future. There is a common perception that Medicare Risk Adjustment (MRA) is all about the money. Is it? It always does come down to the money, but the managed-care MRA model is vastly different from the Fee for Service (FFS) model; the reasons that it is about the money are also different. The MRA model creates an interesting and significantly satisfying outcome for those who understand the system’s whys and wherefores.