Individuals who have experienced a recent fall or are having difficulty with balance may receive a fall risk assessment from a healthcare professional. Medicare covers these assessments during ...
Paul D. Jacobs ([email protected]), Agency for Healthcare Research and Quality, Rockville, Maryland. There is widespread agreement that taxpayers pay more when Medicare beneficiaries are enrolled in ...
Medicare Advantage (MA) insurers, namely industry titans UnitedHealth Group and Humana, could be using health risk assessments and chart reviews to inflate payments from Medicare through upcoding, ...
Medicare Advantage plans have come under fire for upcoding that can increase the payouts they receive, and regulators point to health risk assessments as a likely culprit in this increase in coding ...
A recent OIG report found that diagnoses reported in 2022 Medicare Advantage (MA) encounter data based only on health risk assessments (HRA) and HRA-linked chart reviews resulted in CMS making ...
Some limits on how the assessments are used for adding new diagnosis codes might be justified to ensure Medicare Advantage plans aren’t overpaid, researchers wrote. Under MA, insurers contract with ...
Medicare may use questionnaires at various times to collect information. One of the main questionnaires is the Medicare Current Beneficiary Survey (MCBS). Medicare may ask an individual to fill in a ...
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