Services
Risk Adjustment
The challenging task of managing your risk adjustment data can be labor intensive and stressful. Our expert staff will educate your organization to optimize your risk score, which may increase your revenue. Most PACE organizations that use our risk adjustment management service will recoup the entire expense of our services and more. Let us handle the details for you. Peak PACE Solutions services include:
- Submitting risk adjustment data at least quarterly to CMS based on claims and in-center encounters received
- Following up and correcting any errors in risk adjustment data
- Submitting return files and the HCC MOR and MMR reports to the PACE Data Analysis Center (PDAC)
- Participant-level reports of diagnoses prior to submission for appropriateness review by clinical staff
- Annual on-site training for Medical Directors and PCPs
- Semi-annual analysis of Risk Adjustment Data to identify variances from PACE medians for high volume & high risk HCC codes
- Reporting back to the PACE site any ICD-9 code that is used on an internal encounter that is no longer valid
- Ongoing RAPS training for non-clinical staff
- Customized auditing services available at negotiated rates
“ … advice was very useful.”
Whit Walker
Basics at Jan Werner PACE Program
Amarillo, TX