Resources Portlet

Resources

EDUCATION & EVENTS

ENROLLMENT & CREDENTIALING

FORMS & MANUALS

PHARMACY

POLICIES & GUIDELINES

PROGRAMS & INITIATIVES

AMA/FEP Hypertension Management Project

Behavioral Health

Choosing Wisely®

Documentation & Coding

Healthcare Reform

NCQA Diabetes Recognition Program

NCQA Patient-Centered Medical Home

Opioid Management

Patient Satisfaction

Physician Performance Assessment (PPA)

Preferred Radiology Program

Radiation Therapy Management

Select Programs

Telemedicine

Urgent Care Choice

PROVIDER eSOLUTIONS

PROVIDER NETWORKS

Dynamic Rendering Portlet

Documentation & Coding

Documentation and Coding

The federal government reimburses health plans based on the health of their members, similar to the way Medicare Advantage plans are reimbursed. This reimbursement is determined through a method used by the Centers for Medicare and Medicaid Services (CMS) called "risk adjustment." See our Stars and Risk webpage for more information.

Providers play an important role in the risk adjustment process because claims coding data is used to indicate the complete picture of health for plan members. This same data also enables Blue Cross and Blue Shield of Alabama to plan, analyze and design programs to help manage members' chronic conditions.

Use our documentation and coding resources below to provide the most accurate, complete coding and documentation possible.

Coding

Tips

Guides

Documentation

Medical Record Reviews

Guide to Closing Patient Gaps for the Diabetes Eye Exam Measure