Risk Adjustment Documentation and Coding Boot Camp

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Risk Adjustment Documentation and Coding Boot Camp

Product Code: OCBC


1st Attendee $1,399.00*
Additional Attendee(s)
Save $0.00$1,399.00 each

Total:
$1,399.00
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ACDIS members save $150 off the registration fee.
To register multiple attendees or receive your special discount rate or sign up to become an ACDIS member, contact our sales team at 615-724-7200 or email
PD-IS@SimplifyCompliance.com.

Highly Recommended Material:
ICD-10-CM Expert for Hospitals/Payers
is HIGHLY recommended material for this boot camp.

Looking for the Virtual Class? Click Here.

This live boot camp is best for those looking for an interactive learning experience. Classes are led by our expert instructors, take place over the course of a week, and allow instructor/student interaction and engagement.

Risk Adjustment Documentation and Coding Boot Camp

Course Overview

Risk score training beneficial for both Coding and CDI professionals

Risk adjustment requires coding and CDI professionals to work together as one team to ensure the capture of the most appropriate risk score for each patient.

If you’re looking for ways to expand your CDI department into outpatient settings and services—all of which can impact risk scores—you’ll find it in the Risk Adjustment Documentation and Coding Boot Camp.

The Risk Adjustment Documentation and Coding Boot Camp not only addresses compliant coding practices, but also the reporting requirements related to valid risk adjustment scoring.

This course applies the core concepts of Clinical Documentation Integrity related to record review and provider education, allowing both coding professionals and CDI specialists to accurately capture a patient’s complexity and accurate risk scoring.

The process of risk adjustment accounts for known health conditions, allowing for comparison of wellness amongst patients. Most risk adjustment models utilize diagnosis codes to determine potential risks. The variables pulled from documentation can assist in identification of those patients with a higher medical need than others. The process of risk adjustment is used to predict both costs and allow for comparisons related to quality-of-care measures.

This course reviews various risk adjustment methodologies with a deep focus upon CMS Hierarchical Condition Categories. A review of risk score calculation and those diagnoses/conditions that offer impact will assist your efforts and success is risk adjustment reporting.

Who should take this course?
This course benefits professional coders, CDI specialists, directors and managers of HIM and CDI, providers, physician practice managers, revenue cycle staff, and professionals in the payer setting who administer risk-adjusted plans.

Risk adjustment concepts from this class can also be applied by professionals who monitor quality measures related to the Hospital Value-Based Purchasing (HVBP) Program and Physician Quality Reporting.

This boot camp will help you to:

  • Have a detailed understanding of risk adjustment and identify diagnoses and conditions that affect risk scores
  • Utilize the official guidelines for Coding and Reporting to assign codes
  • Recognize a reportable diagnosis and identify elements to support code assignment
  • Assist providers in strong documentation in support of successful audit results

Leave this boot camp with an understanding of:

  • Risk adjustment’s role in reimbursement and CMS’s quality measures
  • CMS HCC and risk adjustment scoring
  • The CAP- Official Guidelines for Coding and Reporting, as well as what the correct codes are for common diagnoses that affect your risk score
  • Strong documentation in support of RADV audits
  • Documentation requirements to support accurate risk score capture
  • The 2021 Coding Guidelines and new HCC mappings

See the HCPro difference for yourself!

Expertly designed course materials: Materials are developed by our instructors specifically for this intensive learning format.

Hands-on learning: Attendees complete a set of exercises/case studies after appropriate modules to ensure that they understand the concepts and know how to apply them to real-world situations.

Small class size: Class size is limited to ensure individual attention.

Nationally recognized educators: HCPro is the nation's premier organization offering boot camp training courses to healthcare coding professionals.

Our boot camps are a comprehensive and effective way to strengthen your understanding of CDI. “Our goal as instructors is to offer detailed, thorough, and timely education that can be simply broken down and easily understood and applied in daily practice,” says CDI education director at HCPro, Laurie Prescott.

Need Coding education?

For best-in-class Coding education, find out more about our boot camps: https://hcmarketplace.com/product-type/boot-camps/coding

Looking to train your whole team? We can bring our expert instructors to you! Learn more here!

For more detailed information about our Boot Camps, contact us at 615-724-7200 or email PD-IS@SimplifyCompliance.com.

Risk Adjustment Documentation and Coding Boot Camp

Course Locations & Dates

Below is the current course schedule for upcoming classes of this Boot Camp. We update this schedule on a regular basis. 

Registrations are processed in the order received. Class size is limited, and classes often sell out. We recommend against making travel arrangements until after we have confirmed your course registration. 

To register for a class, click the "Register" button. If you would like to register multiple attendees, fill in the "Additional Attendees" box or contact us at 615-724-7200 or email us at PD-IS@SimplifyCompliance.com.

Locations marked as "Tentative" are subject to change. To view our cancellation policy, click here.

October 2022


Phoenix (Chandler), AZ

 

October 3 – 5, 2022
8:00 a.m. – 5:00 p.m. (Day 1–3)

Hyatt Place Phoenix/Chandler - Fashion Center
3535 W. Chandler Boulevard
Chandler, AZ 85226
480-812- 9600
Hotel website


Room Rate: $110/night
Room Rate Cut-Off: September 12, 2022

 

December 2022


Miami, FL

 

December 5 – 7, 2022
8:00 a.m. – 5:00 p.m. (Day 1–3)

Hyatt Place Miami Airport West/Doral
3655 NW 82 Avenue
Miami, FL 33166
305-718-8292
Hotel website


Room Rate: $119/night
Room Rate Cut-Off: November 13, 2022

 

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Risk Adjustment Documentation and Coding Boot Camp

Outline/Agenda

Module 1: Introduction to CMS Reimbursement

  • Summary of Medicare Parts A-D
  • Inpatient Prospective System (IPPS)
  • Outpatient Prospective System (OPPS)
  • Medicare Advantage Plans
  • Prescription Drug Coverage


Module 2: Diagnosis Selection and Documentation

  • Sources of authority for ICD-10-CM coding
  • Documentation sources
  • Diagnosis coding – Inpatient services
  • Diagnosis coding – Outpatient/professional services
  • Uncertain diagnoses
  • Signs/symptoms
  • Comparative/contrasting diagnoses
  • Acute and chronic conditions
  • Combination codes
  • ICD-10-CM conventions


Module 3: Introduction to Risk Adjustment

  • Risk Adjustment Models
    • HHS- HCCs
    • CDPS
    • Elixhauser Comorbidities
    • DRGs
    • CMS-HCCs
  • Demographic Variables
  • Hierarchical Condition Categories
    • Applicable Settings
    • Approved Providers
    • Hierarchies
    • Disease & Disabled Interactions
  • Medicare Advantage Plans
  • Calculating a Risk Score
  • The Role of Disease Interactions


Module 4: The “Hierarchies”


Module 5: Risk Adjustment Data Validation Audits (RADV)

  • Historical necessity for RADV audits
    • OIG Work Plan 2017-2018
    • Fraud Investigations
    • What is a RADV audit?
    • Impacts of RADV audits
    • RADV submission requirements/checklists
    • Querying for clinical validity
    • Internal auditing/reviews


Module 6: Compliant Query Practice


Course Outline/Agenda subject to change.

Risk Adjustment Documentation and Coding Boot Camp

Questions/Answers

What is the focus of the Risk Adjustment Documentation and Coding Boot Camp? 
This course delves into the goals and intent of various risk adjustment methodologies. It will offer an in-depth review of the CMS Hierarchical Condition Categories (HCC), including how risk adjustment scores are assigned and the process of Risk Adjustment Data Validation (RADV) audits. The Boot Camp will discuss how coding and clinical documentation integrity (CDI) professionals can affect these processes.

The Official Guidelines for Coding & Reporting will be reviewed as it relates to risk adjustment diagnosis coding. This course will review correct coding for common diagnoses that can impact your risk scores. It will identify opportunities for query and further clarification, and offer tips for provider education.

Does HCPro offer this Boot Camp as an on-site? 
In addition to our open registration courses, we also offer the Boot Camp as an on-site program (with a substantial discount) for organizations that have a number of employees who need training. For more information on hosting an on-site, call 800-780-0584 or click on "Train Groups On-Site."

What if I need to cancel or transfer my registration? 
To view our cancellation policy, click here

Who typically attends this Boot Camp? 
This course benefits professional coders, CDI specialists, directors and managers of HIM and CDI, providers, physicianICD practice managers, revenue cycle staff, and professionals in the payer setting who administer risk-adjusted plans

Risk adjustment concepts from this class can also be applied by professionals who monitor quality measures related to the Hospital Value-Based Purchasing (HVBP) Program and the Physician Quality Reporting System (PQRS).

What material does the course cover? 
To view the course outline, click on "Course Outline" above.

Does the course require any previous experience or training? 
The course is intended as an introduction to risk adjustment methodologies and the application of coding and CDI practices to capture accurate risk adjustment. It is highly recommended that attendees have existing knowledge of basic diagnosis code assignment as well as basic principles of CDI.

This course is NOT intended to teach coding or basic CDI principles.

Does completion of the course lead to any formal certification? 
The AAPC offers the Certified Risk Adjustment Coder (CRC) examination. For more information, see https://www.aapc.com/certification/crc/.

How is the course taught? 
The course is taught using a combination of lecture, class discussion, and hands-on exercise/case studies.

What do I need to bring to class? 
When you arrive at class, you will receive an extensive notebook of course materials. In addition, please bring the following to all classes: 

  • Current ICD-10-CM Manual
  • A highlighter 
  • A notebook for taking notes 
  • Sticky notes/flags 
  • A pen/pencil 

Does HCPro ever share contact information (e.g., name, address, phone number, email address, etc.) with other companies? 
Historically, we have not shared contact information with anyone outside of our company. However, it is possible that at some point we might share contact information with other companies that offer products and services that we think would be of interest to our customers. If you would like us to keep your contact information confidential, please let us know so that we can flag your information in our customer database as "Do Not Share." 

Does completion of this course assist with preparation towards formal certification?
ACDIS CCDS-O offers a CDI certification related to the outpatient setting. This course will assist in preparation related to exam objectives that focus on risk adjustment.

How do I get more information? 
Contact our sales team at 615-724-7200 or email PD-IS@SimplifyCompliance.com.

Risk Adjustment Documentation and Coding Boot Camp

Things to Know Before Attending Class

Directions and Hotel Information

The hotel address, phone number, URL, room rate and room rate cut-off date are posted on the Locations/Dates tab. The hotel websites give detailed directions to the hotel as well as information about the location.  Please call the hotel directly to make a room reservation.  Be sure to identify yourself as an HCPro Boot Camp participant.  Please be sure to make your reservation before the cut-off date.  After the cut-off date, contact the hotel to determine room availability and rates.

ICD-10-CM Manual 

As a part of this class, you will be working in-class exercises requiring code assignment. It is highly suggested that you have an ICD-10-CM manual to participate in this course.

ICD-10-CM for Hospitals – 2022
https://hcmarketplace.com/2022-icd-10-cm-hospitals-payers

OR if you are a professional services coder, you may prefer

ICD-10-CM for Physicians – 2022
https://hcmarketplace.com/2022-icd-10-cm-physicians

Classroom Time

It is an understatement to say that this course is intense.  Other than breaks, we will be in class from 8:00am to 5:00pm. Monday-Thursday, and from 8:00am to 1:00pm on Friday.  There will be about a one hour lunch break each day. If the class gets behind, class may run later than 5:00pm.   

Lunch

We will take about a one hour break for lunch each day.  Although we typically provide coffee in the morning and drinks and snacks in the afternoon, everyone is on their own for lunch.  Note that many hotels do not have restaurants on-site.  If you are flying to the course, we generally recommend renting a car.

What to Bring to Class

We recommend you bring the following to all classes:

  • Your current ICD-10-CM manual is highly suggested
  • Notepaper
  • Sticky Notes/flags
  • Pen/Pencil
  • Highlighter
  • Layered clothing (e.g., light sweater, light jacket, etc.)

Course Materials

The course materials used in connection with the Risk Adjustment Documentation and Coding Boot Camp® have been specifically designed for use with this course.  We have invested a tremendous amount of time, money and effort in developing, refining and maintaining these materials. As a course participant, you will receive a complete copy of our materials.  However, we do not permit our materials to be used for any purpose other than in direct connection with your participation in this course or as a personal reference in your day-to-day work.

Use of Laptop Computers or Electronic Devices

Our instructors demonstrate where to find many resources on the CMS website. If you have access to a laptop or tablet you may bring it to class to follow along, but you may wish to consider the power and wireless needs of your device. Many conference rooms do not have plugins situated conveniently to the tables so you may wish to ensure you have sufficient battery power. HCPro does not purchase group wireless access for the conference rooms, but many hotels provide free wireless access.  You may wish to confirm your connectivity options prior to arriving at the hotel.  Please be courteous in your use of electronic devices.  Use of electronic devices should not disrupt the class or disturb other participants.  HCPro is not responsible for lost, stolen or damaged devices.  Maintaining the security and safety of your device is your responsibility.  Cell phone use during class is strictly prohibited.

Dress

Business attire is not necessary.  Please dress comfortably.  Also, we find that the classrooms are sometimes on the cool side, even during the warmer months.  You may be more comfortable if you bring a sweater or sweatshirt in case you get cold.

Copyright Protection of Course Materials

You will receive a complete copy of our course materials at the beginning of class.  The materials used in connection with this course were custom designed by our company specifically for use in connection with this course.  We have invested a tremendous amount of time, money and effort in developing, refining and maintaining these materials and they are protected by copyright laws.  Course materials may not be duplicated.  You may use the materials (i) in direct connection with the course or (ii) as a personal reference in your day-to-day work.  No claim is asserted to any U.S. Government, American Medical Association or American Hospital Association works included in the course materials workbook. 

Cancellation and Transfer Policy

For our cancellation and transfer policy, visit our website:  http://hcmarketplace.com/cancellations

COVID Safety

Simplify Compliance and HCPro place the highest priority on the safety of our guests. In preparation for attendance at our events, we want to share the following measures to promote health and well-being:

  • If the region where our event is located is deemed by the CDC to be within the substantial or high-risk category, we will require all attendees, regardless of vaccination status, to wear masks when indoors except while actively eating or drinking. 
  • Meeting rooms will be set to support social distancing when necessary.
  • Food service will follow the safety guidelines implemented by the hotel. 

To view all the safety measures that a specific hotel has implemented, please see the information listed on their website.

Simplify Compliance and HCPro will continue to monitor the COVID-19 environment and the recommended guidelines, and will communicate adjustments to the onsite policies and procedures as necessary.

Contact Information

For more information about our Boot Camps, contact us at 615-724-7200 or email PD-IS@SimplifyCompliance.com.

We Look Forward to Having You In Class!

Risk Adjustment Documentation and Coding Boot Camp

Learning Objectives

At the conclusion of this educational activity, participants will be able to: 

  • Discuss predictive modeling and the concept of risk adjustment 
  • Explain how risk adjustment is applied to reimbursement in healthcare 
  • Explain how risk adjustment is applied to CMS quality measures 
  • Identify the different models used in risk adjustment 
  • Discuss the process of computing the Risk Adjustment Factor (RAF) score for individuals 
  • Describe the process of Risk Adjustment Data Validation (RADV) audits 
  • Identify elements within a medical record that can be used to support code assignment 
  • Define what is considered a reportable diagnosis 
  • Identify the most common conditions found within the Hierarchical Condition Categories (HCC) risk adjustment methodology 
  • Apply the Official Guidelines for Coding and Reporting when assigning codes to these common conditions 
  • Identify query opportunities related to documentation deficiencies that would likely impact HCC assignment and RAF score 
  • Apply the process of record review for HCC risk adjustment to clinical examples

Continuing Education

Association of Clinical Documentation Integrity Specialists (ACDIS)
This program has been approved for 22.5 continuing education units towards fulfilling the requirements of the Certified Clinical Documentation Specialist (CCDS) certification and CCDS-O (outpatient) certification, offered as a service of the Association of Clinical Documentation Integrity Specialists (ACDIS).

AAPC
This program has the prior approval of AAPC for 22.5 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

American Health Information Management Association (AHIMA)
This program has been approved for 22 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

Accreditation Council for Continuing Medical Education (ACCME) 
HCPro is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

HCPro designates this educational activity for a maximum of 22.5 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity

American Nurses Credentialing Center (ANCC) 
HCPro is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This educational activity for 22.5 nursing contact hours is provided by HCPro.

California Board of Registered Nursing 
HCPro is approved by the California Board of Registered Nursing to provide 27 nursing contact hours. California BRN Provider #CEP 14494.


Disclosure Statement: 
HCPro has confirmed that none of the faculty/presenters, planners, or contributors have any relevant financial relationships to disclose related to the content of this educational activity.

Risk Adjustment Documentation and Coding Boot Camp

COVID

Simplify Compliance and HCPro place the highest priority on the safety of our guests. In preparation for attendance at our events, we want to share the following measures to promote health and well-being:

  • Per current CDC guidelines, if the county where our event is located is deemed to be within the high level of COVID-19, it will be recommended that all attendees, regardless of vaccination status, wear masks when indoors except while actively eating or drinking.
  • Food service will follow the safety guidelines implemented by the hotel.

To view all the safety measures that a specific hotel has implemented, please see the information listed on their website.

Simplify Compliance and HCPro will continue to monitor the COVID-19 environment and the recommended guidelines and will communicate adjustments to the onsite policies and procedures as necessary.