Additional Consultation Options
Risk Adjustment Consultation Peak PACE Solutions will help you to understand the risk adjustment preparedness process and will support operationalizing processes to promote appropriate risk adjustment. As a result, you reduce your risk for either under- or overpayment.
Risk Adjustment Consultation Overview
Situational Analysis
- Risk adjustment process survey
- Reviewing and analyzing source documents (MMR, MOR, PDAC reports, internal analyses)
- Identifying known issues or problems
“ … I highly recommend Dr. Schamp.”
Whit Walker
Basics at Jan Werner PACE Program
Amarillo, TX - Risk Adjustment HCC audit is optional
Desk Review and Data Mining
- Reviewing historical risk adjustment performance
- Comparing HCC distribution reports
- Reviewing sample of charts with primary care provider notes
- Establishing strategic goals
Risk Adjustment Workshop on site includes training for:
- Internal coding and reporting processes
- Administrative, coding, and analyst staff
- Medical director and PCPs
- Executive update
Fraud, Waste and Abuse Audit
This two-part Peak PACE Solutions training session can include a mock mini-data validation survey and a fraud, waste and abuse audit.
Training Overview
Situational Analysis
- Administrator site compliance/FWA survey
- Discussing known problems or issues
Desk Review
- Reviewing enrollment/payment/PDE compliance
- Reviewing compliance plan
Fraud, Waste and Abuse Workshop
- Reviewing general understanding of compliance plan
- Administrative, pharmacy, back-office, and staffing review
- Executive update