Risk Adjustment Masterclass
We have developed an all inclusive deep dive into Risk Adjustment designed for those new to the field and for those well versed to get a comprehensive review and stay up to date on the guidelines for this vital area of Reimbursement
What is
Risk Adjustment
In its basic definition it encompasses using a statistical process that reviews the patients health conditions and the cost of the health plan enrollee to analyze their health outcome and/ or health care costs.
Risk Adjustment takes in so much more from understanding regulatory guidelines, understanding the different types of Audits that must be done, ensuring accurate documentation and coding is abstracted according to the official Guidelines. You must also know the different payment models used by CMS, Commercial Carriers, Medicaid and Rx plans.
What will I learn?
Course Objectives
- Identify the purpose of the ICD-10-CM code set and interpret Guidelines
- An overview of Risk Adjustment and its Methodologies
- Understand the Various Regulatory Guidelines
- Developing Internal policies to achieve an effective Risk Adjustment Program
- Learn the Documentation requirements for acceptable documentation
- Learn the basics of Pharmacology as it relates to properly abstracting ICD10-CM Codes for reimbursement
- Identify each payment model and its hierarchY
- Learn how to perform RADV, Prospective and Retrospective Audits
- Understand Predictive Modeling through the Data capture process
- Identify the aspects of Quality Scores
- Understand Anatomy and Medical Terminology when reviewing and abstracting codes
About Me
Jennifer McNamara CPC,CCS,CPMA,CRC,CGSC,COPC AAPC Approved Instructor
I am the Director of Education here at Ozark Institute and will bring you impact and results with my 18+ years of proven healthcare revenue cycle experience and effective instruction for 1000+ students as of 2021. I have learned to embrace the changes in the billing and coding space by embracing the movement to value based care and software deployment across specialties.
I am committed to teaching others the intricate world of billing and coding and the future of the space. Check out my weekly Podcast “Life as a Coder” for more information on The Business of Healthcare.
Have Any Questions?
FAQ's
We know you have many questions. Here are the answers to our most common questions.
Who Should Take an Online Course?
Our Online courses are designed for those who are self starters and love learning new things. Of course all students get access to our team when you have questions, or you can purchase a Course Membership option.
How Do I Access My Course?
Once you purchase a course, you will login to your account on the website to view all the courses you have registered for.
Are There Prerequisites or Language Requirements?
We do not have any pre requisite requirements but for Full courses such as CPC or CCS Exam prep we recommend taking our Anatomy course prior or simultaneously. The courses are presented in English.
Can I Take More than One Course at a Time?
Yes. You can take as many classes or webinars that you would like. All courses and webinars are available all year until March of the following calendar year.
My Payment Did Not Go Through. What Do I Do?
Use the Contact area of the website so we can troubleshoot your issues and arrange for alternative payment options.
How Does Online Learning Work?
The majority of our courses are lecture based with quizzes and/or exams. Following the completion of the content you will receive a CEU Certificate if applicable. Some courses are taken directly on the AAPC® Blackboard site.
You will receive instructions after you register.
How Much will I have to pay?
Great Question! Our course prices vary based on content and length. You can pay from $1200 to $2000 including Course access, Books, Exam and AAPC® or AHIMA® Membership.
How long will I have access to my Course?
We know you may have a busy schedule and many responsibilities so we make it easy to do On Demand and self paced, with access for 1 year. We do caution for Exams that are based on each Calendar year that you stick with the provided Syllabus and 8 to 16 week Schedule in order to test in the Calendar year your books are designed for.
Codes do change annually and we want you to be able to test with the books you have taken all of your notes in. If you cannot finish all you have to do is purchase new year books for next year and transfer your notes. You will also want to review the new book for Code changes and review those guidelines.
What Books will I need?
Depending on the Course you take you will need one or more of the Following books:
- 2022 CPT® Current Procedural Terminology Published by AMA®
- 2022 ICD10-CM(International Classification of Diseases Clinical Modification, 10th Revision) Any Publisher(Expert Recommended)
- 2022 HCPCS(Healthcare Common Procedural Coding System) Any Publisher
- Course Training Manual Included with course material
- Medical Dictionary of your choice(Steadmans Recommended)
Will I be able to find a Job after I am Certified?
That is the question we get most often. With any industry, when a Certification is a requirement then its the first step. As educators we cannot guarantee anything but we do offer Job Coaching and Resume Assistance discounts with our Partner Project Resume
There are many roads that lead to the right job for you and we will help you find it. Many of our 2021 Graduating students have found work and we will be here to help you as well.
Many find it easier to find employment as a Risk Adjustment coder as the CRC® credential does not have an apprentice status. Many employers will hire you with little to no experience.
What do I do between finishing the Course and my test date?
Well your work is not done. You will be working hard to finalize your notes in your books, taking many practice exams and completing your Exam Review. We will be here for you for a final prep session 1 week before your exam.
Ready to Start
Let’s get you started down the right path and Level up your Career
