Many claims have already left your office for the payer’s desk. What can we learn from submitted claims that can strengthen your methodologies and inform your internal education? In this session, we’ll explore internal documentation reviews and the many lessons we may learn from a post-visit analysis. Are your payers giving appropriate credit for conditions already managed, creating a current and accurate revalidation list? Are your providers capturing all the concerns that were addressed at the visit or that impacted care? Is specificity captured at it’s highest level, and if not, is the problem in the documentation or the code? Note that where risk revalidation opportunities exist, payer programs may offer monetary incentives. If risk gaps are closed and dollars are brought in, does this work help pay for the additional hours spent in your risk revalidation process?
