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.
Medical Record Reviews
CPT codes, descriptions and data copyright ©2018 American Medical Association. All rights reserved. Applicable FARS/DFARS apply.
CDT codes, descriptions and data copyright ©2018 American Dental Association. All rights reserved.
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