Our Journey Of Compliance

Our Journey Of Compliance

Our journey, from the conception of a compliance strategy for our company, to developing a full-fledged culture and integrating it completely with operations might be of some value to others. Let me share a little of what the journey was like.  It was circa 2004 that I asked a known professional who had audited charts...

Risk Adjustment: A Compliant, Efficient And Medicine-Based Approach

Risk Adjustment: A Compliant, Efficient And Medicine-Based Approach

As premiums continue to be reduced, Health Plans, IPAs, MSOs, and medical groups must have plans in place that ensure an accurate RAF score. To obtain these, healthcare organizations must not only recapture the enrollee’s prevalent conditions but compliantly report clinical conditions as they appear.  Several organizations have been “playing with numbers” to project future...