June is GO Time for Risk Adjustment: Your Program Check List

June 9, 2011
|In Risk Adjustment
|By GHG Advisors

It’s June!  And most people are thinking about summer vacation… unless, that is, you work in risk adjustment. 

This is Go Time.

Those living in the risk adjustment world should have their programs designed and launched by now.  Are you on target?  Here’s your checklist:

  • Chart Review: List Developed, Outreach Done, Collection and Coding Started
    • Goal: 20-30% by the end of June
  • Hospital Data Collection: You’ve contacted your high admission hospital and you are on schedule for receiving tons of hospital data electronically by August 15th to insert into your September Sweeps.
    • Goal: All 2010-2011 through QTR 2 in by August 15th
  • Prospective Evaluation: List developed, outreach done, evaluation scheduling started
    • Goal: You should be sitting at about 20-20% completed

After doing this for the year, we realize that from Thanksgiving to the New Year the physician offices, hospitals, and members are much harder to reach.  Retrieval and closure rates fall significantly.

Save your vacation requests for a winter getaway … It is Go Time Now