PA Resources Portlet

Resources

CODING & DOCUMENTATION

EDUCATION & EVENTS

ENROLLMENT & CREDENTIALING

FORMS & MANUALS

PATIENT HEALTH

PHARMACY

POLICIES & GUIDELINES

PRE-SERVICE REVIEW

PROGRAMS & INITIATIVES

PROVIDER eSOLUTIONS

PROVIDER NETWORKS & SPECIALTIES

PA Dynamic Rendering

Back

Coding Corner

The federal government reimburses Medicare Advantage plans based on the documented health of their members through a method used by CMS called "Risk Adjustment." This reimbursement is based on the anticipated cost of members' healthcare and is what health plans rely on to accurately estimate healthcare costs and provide high-quality affordable Medicare Advantage products.

Providers play an important role in the risk adjustment process. Medical record documentation and claims coding data are used to help indicate the complete picture of health for plan members. This data also enables Blue Advantage to analyze and design programs to help manage member care.

Documentation and coding must mirror one another in order to accurately capture the patient's complete picture of health. Use our resources below to provide the most accurate, complete coding and documentation possible. 

Please note: If you are not a registered ProviderAccess user, some of the content will not be viewable. Contact the practice administrator for your associated practice for a user ID and password.  

Documentation and Coding Tips

Risk Webcasts

Strategies for Improving Medication Adherence
May 2022

 

Rheumatoid Arthritis
December 2021

 

COPD
December 2021

 

Vascular Disease Part 2
December 2021

 

Cancer
December 2021

 

Diabetes
July 2021

 

Vascular Disease
July 2021

 

Depression
July 2021

 

Heart Failure
July 2021

 

Clinical Review of Medicare Advantage Risk Adjustment and Chronic Condition Coding
September 2020