The Pulse: Risk Adjustment Insights from an Industry Expert

Welcome to AAPC’s new podcast, The Pulse. Hosted by expert, Lori Cox, MBA, CPC, CPMA, CPC-I, CEMC, CGSC, CHONC, each episode will feature interviews with healthcare leaders to discuss industry updates and uncover relevant, actionable advice to help you improve your revenue and eliminate risks.

Risk Adjustment (RA) is a complicated and fast-growing area in the business of healthcare. In Episode One, Lori Cox sits down with Dr. Khush Singh, a well-known risk care management consultant, to talk about lawsuits related to RA, increased activity from OIG and the Department of Justice, and to answer questions like:  

• Due to these risk adjustment lawsuits, what changes do you see coming in the next few years? 

• What role do coders play in the quality of care? 

• Do you think we will be able to pull diagnosis from other types of documentation?  

• What advice do you have for providers participating in managed Medicare plans?  

Plus, they discuss ACA and Medicare Advantage Risk Adjustment programs, CMS demanding payback, and more.