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Risk Adjustment Coding Workgroup: December 2024

Event Date: 12/12/2024

Event Overview

Thursday, 12/12/2024
1:00 PM CT – 2:30 PM CT (90 minutes)
Hosted by: Health Plan Alliance

The Alliance Coding Workgroup brings together individuals within Alliance member health plans, health systems, or provider groups who have responsibility for coding, documentation, or other activities related to RADV audits for Medicare Advantage and Commercial/Exchange products. Each call is hosted by a health plan that will share a selection of medical charts with the group for feedback on risk adjustment coding best practices.

The medical charts are shared at least two weeks in advance of each call. Participants should review the charts, complete the pre-work questions, and come prepared to share how they would code each chart and supporting documentation source(s), if applicable.

 

PLATFORM NOTES: The roundtable discussion will be hosted on Zoom.

Audience

Certified coders and managers with responsibility for the oversight of risk adjustment coders, as well as plan staff with responsibility for physician training around accurate and specific documentation related to coding.

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Documents
12/13/2024

Recording: Coding Workgroup December 2024
The Alliance Coding Workgroup brings together individuals within Alliance member health plans, health systems, or provider groups who have responsibility for coding, documentation, or other activities related to RADV audits for Medicare Advantage and Commercial/Exchange products. Join Tammy Allen and Joshua Dearstyne-Judge with CDPHP and your Coding Workgroup peers to review the selected case studies and discuss how to code them.

12/11/2024

Coding Work Group Session 5 Pre-Survey Results
Explore the pre-survey results for session 5 facilitated by Capital District Physicians' Health Plan.

11/20/2024

Coding Workgroup Case Studies Packet December 2024
Collaborate with your Alliance peers on risk adjustment coding best practices. Capital District Physicians' Health Plan shares a collection of recently coded medical charts to discuss the results as a group and share best practices.

Attendees

Below is a list of all delegates registered to date for this event

  • Keri Bloomer
  • ALLIANCE GUEST
  • Director of Operations at Health Plan Alliance
  • Dega Abdi
  • ALLIANCE MEMBER
  • Risk Adjustment Coding Auditor at MediGold
  • Lisa Alexander
  • ALLIANCE MEMBER
  • Point of Service Coding Analyst at Health Alliance Medical Plans
  • Judith Armstrong
  • ALLIANCE MEMBER
  • Risk Adjustment Quality Assurance Auditor at Capital District Physicians' Health Plan (CDPHP)
  • Karen Artress
  • ALLIANCE MEMBER
  • Outpatient CDI Specialist at Health Alliance Plan (HAP)
  • Amy Atkins
  • ALLIANCE MEMBER
  • Medical Records Specialist II at Community Health Plan of Washington
  • Chelsea Avellino
  • ALLIANCE MEMBER
  • Quality Coding and Documentation Educator II at Geisinger Health Plan
  • Carolyn Baca
  • ALLIANCE MEMBER
  • Risk Adjustment Reviewers at Presbyterian Healthcare Services
  • Julie Bartels
  • ALLIANCE MEMBER
  • Risk Adjustment Analyst at Quartz Health Solutions
  • Traci Biondi
  • ALLIANCE MEMBER
  • Chief Medical Officer at Prominence Health Plan
  • Kranthi Biragoni
  • ALLIANCE MEMBER
  • Senior Coding Analyst at Providence Health Plan
  • Pamela Bower
  • ALLIANCE MEMBER
  • Program Manager, Risk Adjustment at Presbyterian Health Plan
  • DeeEl Brovetto
  • ALLIANCE MEMBER
  • Risk Adjustment Auditor II at Baylor Scott & White Health Plan
  • Angela Bruck
  • ALLIANCE MEMBER
  • Outpatient Clinic CDI at Happify
  • Heather Buckley
  • ALLIANCE MEMBER
  • Risk Adjustment Auditor at Baylor Scott & White Health Plan
  • Sarah Burke
  • ALLIANCE MEMBER
  • Lead Quality Auditor at Health First Health Plans
  • Sandra Caron
  • ALLIANCE MEMBER
  • Medical Coder at Neighborhood Health Plan of Rhode Island
  • Amber Carroll
  • ALLIANCE MEMBER
  • HCC Coding Analyst at SelectHealth
  • Kayleigh Cavano
  • ALLIANCE MEMBER
  • Risk Adjustment Coding Auditor at MediGold
  • Kelly Chan
  • ALLIANCE MEMBER
  • Supervisor, Risk Adjustment Coding at Presbyterian Health Plan
  • Ashley-Jo Chapin
  • ALLIANCE MEMBER
  • Risk Adjustment Compliance Nurse at Geisinger Health Plan
  • Patricia Christie
  • ALLIANCE MEMBER
  • Risk Adjustment Manager at Providence Health Plan
  • Jackie Chu Shing
  • ALLIANCE MEMBER
  • Risk Adustment Coding Auditor at SelectHealth
  • Deb Curry
  • ALLIANCE MEMBER
  • Director Risk Adjustment & Recoveries at Medical Mutual
  • Kaitlyn Daigle
  • ALLIANCE MEMBER
  • Risk Adjustment Coding Auditor at Health New England
  • Melanie Davis
  • ALLIANCE MEMBER
  • Clinical Risk Assessment Coordinator at Health Partners Plans / Jefferson Health Plans (HPP/JHP)
  • Nicole Davis
  • ALLIANCE MEMBER
  • Risk Adjustment Coder at Baylor Scott & White Health Plan
  • Colleen Degenhardt
  • ALLIANCE MEMBER
  • Risk Adjustment Compliance Analyst at Quartz Health Solutions
  • Wendi Dillon
  • ALLIANCE MEMBER
  • Risk Adjustment Coding and Documentation Specialist at Sentara Health Plans
  • Crystal Djordjevic
  • ALLIANCE MEMBER
  • Point of Service Auditor/Educator at Health Alliance Medical Plans
  • Kathleen Dress
  • ALLIANCE MEMBER
  • Senior Coder - Risk Adjustment at Geisinger Health Plan
  • Kathy Edmonds
  • ALLIANCE MEMBER
  • Risk Adjustment Coding & Documentation Specialist at Sentara Health Plans
  • Lynn Ellis
  • ALLIANCE MEMBER
  • Coder Program Trainer at Geisinger Health Plan
  • Katie Engel
  • ALLIANCE MEMBER
  • Clinical Transformation Educator at Geisinger Health Plan
  • Doris Ewing
  • ALLIANCE MEMBER
  • Coding Analyst at Health Alliance Medical Plans
  • Miranda Flango
  • ALLIANCE MEMBER
  • Coding Program Trainer at Geisinger Health Plan
  • Kristine Forrest
  • ALLIANCE MEMBER
  • Health Risk Coding and Education Specialist II at Health Alliance Plan (HAP)
  • Samantha Gallow
  • ALLIANCE MEMBER
  • Risk Adjustment Coder and Documentation Specialist at Sentara Health Plans
  • Kay-Ann Graham
  • ALLIANCE MEMBER
  • Risk Adjustment auditor at Health First Health Plans
  • Janet Green
  • ALLIANCE MEMBER
  • Medicare Compliance at Sentara Health Plans
  • Lisa Guarinoni
  • ALLIANCE MEMBER
  • Manager, Coding & Clinical Documentation at Ochsner Health Plan
  • Kelly Hall
  • ALLIANCE MEMBER
  • Risk Adjustment Coder & Documentation Specialist at Sentara Health Plans
  • Lori Harris
  • ALLIANCE MEMBER
  • Lead Health Risk Coding & Education Specialist at Health Alliance Plan (HAP)
  • Amber Harris
  • ALLIANCE MEMBER
  • Director Risk Adjustment at MediGold
  • Shawn House
  • ALLIANCE MEMBER
  • Registered Nurse at Johns Hopkins Health Plans
  • Jenny Hudson
  • ALLIANCE MEMBER
  • OP CDI SPECIALIST at Health Alliance Plan (HAP)
  • Brad Jacobson
  • ALLIANCE MEMBER
  • Program Manager 2 at Valley Health Plan
  • Karen Jensen
  • ALLIANCE MEMBER
  • Manager, Risk Adjustment and SIU at Quartz Health Solutions
  • Morgan Johnson
  • ALLIANCE MEMBER
  • Risk Adjustment Coding Auditor at SelectHealth
  • Rita Johnson
  • ALLIANCE MEMBER
  • Coding Compliance Specialist / Educator at Presbyterian Health Plan
  • Alyssa Joy
  • ALLIANCE MEMBER
  • Quality Audit Analyst at University of Michigan Health Plan
  • Erin Kalagher
  • ALLIANCE MEMBER
  • Risk Adjustment Coding Specialist at Health New England
  • Vicki Kazmierczak
  • ALLIANCE MEMBER
  • Outpatient CDI Specialist at Health Alliance Plan (HAP)
  • Kaesie Kettinger
  • ALLIANCE MEMBER
  • Senior Risk Adjustment Auditor at Medical Mutual
  • Cassie Lane
  • ALLIANCE MEMBER
  • Associate-Senior Claims Coding at IU Health Plans
  • Sarah Larence
  • ALLIANCE MEMBER
  • Benefit Configuration Sr. Analyst at Presbyterian Health Plan
  • Daniel Larocco
  • ALLIANCE MEMBER
  • Coding Specialist at HealthTeam Advantage
  • Letecia Lear
  • ALLIANCE MEMBER
  • Remote Risk Adjustment Auditor I at Baylor Scott & White Health Plan
  • Adam Letherby
  • ALLIANCE MEMBER
  • Quality CHA Supervisor at Health First Health Plans
  • Melanie Lewis
  • ALLIANCE MEMBER
  • Risk Adjustment Coder at Health Alliance Plan (HAP)
  • Rhonda Long
  • ALLIANCE MEMBER
  • Value Based Coding Educator at Health Alliance Medical Plans
  • Stephanie Long
  • ALLIANCE MEMBER
  • Health Risk Coding & Education Specialist II at Health Alliance Plan (HAP)
  • Taren Long
  • ALLIANCE MEMBER
  • Coding Program Trainer/Auditor at Geisinger Health Plan
  • Jeanne Lui
  • ALLIANCE MEMBER
  • Risk Adjustment Coordinator at CCHP
  • Mary Lupas
  • ALLIANCE MEMBER
  • Project Coordinator, Risk Adjustment at MediGold
  • Marilyn Majors
  • ALLIANCE MEMBER
  • Risk Adjustment Auditor 1 at Baylor Scott & White Health Plan
  • Kathy Mantell
  • ALLIANCE MEMBER
  • Provider Configuration Specialist at SummaCare
  • LuAnn McCarty
  • ALLIANCE MEMBER
  • Risk Adjustment Coder at Community Health Options
  • Angela McGregor
  • ALLIANCE MEMBER
  • Sr Risk Adjustment Coding Specialist at Community Health Plan of Washington
  • Mary McMaster
  • ALLIANCE MEMBER
  • Lead Investigator at CommunityCare
  • Maria Menendez
  • ALLIANCE MEMBER
  • RN/CPC/CRC/CPMA -clinical reviewer at AvMed
  • Meghan Miller
  • ALLIANCE MEMBER
  • Risk adjustment auditor at Baylor Scott & White Health Plan
  • Kylee Millinder
  • ALLIANCE MEMBER
  • Senior Coder-Risk Adjustment at Geisinger Health Plan
  • Jade Moore
  • ALLIANCE MEMBER
  • Risk Adjustment Coding Specialist at Medical Mutual
  • Stephne Morgan
  • ALLIANCE MEMBER
  • Risk Adjustment Program Manager at Health New England
  • Cathy Nagy
  • ALLIANCE MEMBER
  • Manager, Risk Adjustment Coding and Education at Health Alliance Plan (HAP)
  • Donna Norero
  • ALLIANCE MEMBER
  • Clinical Coding Reviewer at Presbyterian Health Plan
  • Jaylene Olson
  • ALLIANCE MEMBER
  • Point of Service Coding Analyst at Health Alliance Medical Plans
  • Michelle Osborne
  • ALLIANCE MEMBER
  • Outpatient Clinical Documentation Specialist at Health Alliance Plan (HAP)
  • Tracy Parent
  • ALLIANCE MEMBER
  • Risk Adjustment Coder at Community Health Options
  • Jana Pennington
  • ALLIANCE MEMBER
  • Risk Adjustment Analytics Manager-Coding at Saint Luke's Health System
  • Lisa Potter
  • ALLIANCE MEMBER
  • Risk Adjustment coder/ Educator/MA Abstract Analyst II at Health Alliance Plan (HAP)
  • Alix Putnam
  • ALLIANCE MEMBER
  • Risk Adjustment Coding Auditor Supervisor at SelectHealth
  • Kylie Rasmussen
  • ALLIANCE MEMBER
  • Risk Adjustment Coding Auditor at SelectHealth
  • Viktoriya Rebrik
  • ALLIANCE MEMBER
  • Sr. Claims Reimbursement and Coding Specialist at Community Health Plan of Washington
  • Noreen Rhoades
  • ALLIANCE MEMBER
  • Program Integrity Manager at Community Health Plan of Washington
  • Heather Richardson
  • ALLIANCE MEMBER
  • Sr. Medicare Compliance Analyst at University of Michigan Health Plan
  • Arianna Riikonen
  • ALLIANCE MEMBER
  • sr risk adjustment analyst at Health First Health Plans
  • Laura Robinson
  • ALLIANCE MEMBER
  • Associate Coding Analyst at Providence Health Plan
  • Maria Rodriguez
  • ALLIANCE MEMBER
  • Risk Adjustment Auditor at Baylor Scott & White Health Plan
  • Pam Ross
  • ALLIANCE MEMBER
  • Fraud Investigator at Geisinger Health Plan
  • Robynn Roy
  • ALLIANCE MEMBER
  • Risk Adjustment Coordinator at Avera Health Plans
  • Melissa Rusk
  • ALLIANCE MEMBER
  • Vice President Operations at SummaCare
  • Kristy Russell
  • ALLIANCE MEMBER
  • HCC Coding Analyst Supervisor at SelectHealth
  • Ivis Salgado
  • ALLIANCE MEMBER
  • RN,CPMA,CDEO,CRC,Clinical Reviewer at AvMed
  • Colleen Schepp
  • ALLIANCE MEMBER
  • Risk Adjustment Auditor at Network Health
  • Michelle Sedillo
  • ALLIANCE MEMBER
  • Risk Adjustment Coder/Reviewer at Presbyterian Health Plan
  • Stefanie Shelton
  • ALLIANCE MEMBER
  • Sr. Claims and Reimbursement Specialist at Community Health Plan of Washington
  • Liz Shubitowski
  • ALLIANCE MEMBER
  • Health Risk Coding & Education Specialist II at Health Alliance Plan (HAP)
  • Courtney Sloan
  • ALLIANCE MEMBER
  • Quality Assurance Auditor at Capital District Physicians' Health Plan (CDPHP)
  • Kelli Smith
  • ALLIANCE MEMBER
  • Risk Adjustment Auditor 1 at Baylor Scott & White Health Plan
  • Barb Smith
  • ALLIANCE MEMBER
  • Clinical Review Coder - Avera Health at Avera Health Plans
  • Rochelle Smith
  • ALLIANCE MEMBER
  • Risk Adjustment Coding Auditor I at SelectHealth
  • Loan Stackhouse
  • ALLIANCE MEMBER
  • Coding at Community Health Plan of Washington
  • Lisa Stanton
  • ALLIANCE MEMBER
  • OP CDI at Health Alliance Plan (HAP)
  • Valerie Steen
  • ALLIANCE MEMBER
  • Sr. Claims Reimbursement and Coding Specialist at Community Health Plan of Washington
  • Deb Sterner
  • ALLIANCE MEMBER
  • Clinical Auditor, FWA at Geisinger Health Plan
  • Joan Stewart
  • ALLIANCE MEMBER
  • Health Services Specialist at Health New England
  • Iris Talbert
  • ALLIANCE MEMBER
  • Clinical Transformation Educator at Geisinger Health Plan
  • Deborah Thomasson
  • ALLIANCE MEMBER
  • Medical Coding Compliance Specialist at Medical Mutual
  • Rhonda Thrift
  • ALLIANCE MEMBER
  • Director, Network Modeling and Pricing at Sentara Health Plans
  • Kyrie-Anne Tran
  • ALLIANCE MEMBER
  • Coding Quality Auditor at Providence Health Plan
  • Tana Turner
  • ALLIANCE MEMBER
  • Risk Adjustment Coding Auditor ll at SelectHealth
  • Daniel Vestboe
  • ALLIANCE MEMBER
  • Coding Analyst at Providence Health Plan
  • Desiree Walke
  • ALLIANCE MEMBER
  • Risk Adjustment Compliance Analyst at Quartz Health Solutions
  • Rebecca Walker
  • ALLIANCE MEMBER
  • Risk Adjustment Coding Manager at Presbyterian Health Plan
  • Kayla Walker
  • ALLIANCE MEMBER
  • Manager of Risk Adjustment at Baylor Scott & White Health Plan
  • Denise Warner
  • ALLIANCE MEMBER
  • Associate Coding Analyst at Providence Health Plan
  • Samia Watkins
  • ALLIANCE MEMBER
  • Outpatient CDI Specialist at Health Alliance Plan (HAP)
  • Heather Webster
  • ALLIANCE MEMBER
  • Clinical Risk coordinator at Health Partners Plans / Jefferson Health Plans (HPP/JHP)
  • Amber Weeks
  • ALLIANCE MEMBER
  • Coding Program Trainer at Geisinger Health Plan
  • Katherine Weinstein
  • ALLIANCE MEMBER
  • Risk Adjustment Quality Assurance Auditor II at Capital District Physicians' Health Plan (CDPHP)
  • Amy Whalen
  • ALLIANCE MEMBER
  • Risk Adjustment Coding Specialist at Neighborhood Health Plan of Rhode Island
  • Mandy Whitley
  • ALLIANCE MEMBER
  • Point of Service Coding Analyst at Health Alliance Medical Plans
  • Tanya Williams
  • ALLIANCE MEMBER
  • Point of service Coding Analyst at Health Alliance Medical Plans
  • Amanda Wozniak
  • ALLIANCE MEMBER
  • Risk Adjustment Coding Auditor at Medical Mutual
  • Leona Zhu
  • ALLIANCE MEMBER
  • Risk Adjustment Coder at CCHP
  • Stephanie Ziegler
  • ALLIANCE MEMBER
  • Manager, Risk Adjustment Coding at Community Health Plan of Washington
Speakers