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The Power Of Quality Review: How Auditing Programs Can Enhance Accuracy & Program Outcomes

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April 12, 2023

“…Examine existing compliance procedures to identify areas where improvements can be made to ensure diagnosis codes that are at high risk for being miscoded comply with Federal requirements and take the necessary steps to enhance those procedures.” – OIG

Do you identify how compliant codes are? In the new heightened regulatory environment, it is more important than ever to invest in a quality assurance program and audit your vendor.

Download our RISE webinar recording to learn more about how you can increase the efficiency and accuracy of your risk adjustment coding program.

Key Takeaways:

  • Understand CMS and industry changes
  • Five key steps to building an efficient and accurate medical coding process
  • Four key metrics to monitor in your quality assurance program
  • Dive into a case study where one MA plan conducted a retrospective coding review and found that 23% of diagnoses found only once in claims were unsupported by OIG data and model inputs

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