UPCOMING EVENT: Meet Episource and Catch Our Presentation at the RISE Risk Adjustment Forum, May 20-22 in New Orleans.  Click to Lean More!

Advance Possibility

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

Quality review - 5 stars
April 12, 2023

According to federal audits, eight of the ten biggest Medicare Advantage insurers have submitted non-compliant, inflated data. To combat this, CMS increased its funding of fraud, waste, and abuse. With CMS audits on the rise, it is very important to have an efficient and accurate medical coding process and a good quality assurance program can help you achieve that.

Learn more by downloading our RISE webinar presentation slide deck, a great tool to help your organization achieve higher than 95% accuracy.

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

Download Resource