Wiki Capitated Plan

Dorthi

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So we have a Humana Capitated plan, we send our notes to our MSO and they code the information for hedis measures etc. So here is our issue

If a patient requires an acer/arb but cannot medically take it we are getting low scores because they are not on it but we are told there is no way to code for the inability to take the medication they either take it you pass the measure or they don't and you fail the measure. Does anyone know how to do this?

They say coding adverse effect of the drug will not help CMS doesn't care if it they cannot medically take the medication.

I am not talking a rash if they take I am talking about death if they take it. Does anyone know anyway around this measure in this instance?

Dorthi
 
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