![]() ![]() So each year, all provider’s documentation of claims needs to be reviewed and accomplished using the MEAT criteria so as not to miss any detail in the medical records of patients. Since Medicare claims are renewed and re-assessed yearly, commencing every 1st of January, it is critical to capture all chronic conditions of Medicare beneficiaries in order to receive proper and maximum reimbursement. Maximized annual Medicare claims and reimbursement Since CMS conducts RADV for every beneficiary claim for Medicare Advantage (MA) risk adjustment payment, it is crucial for the MEAT coding criteria to be competently implemented and thoroughly followed by the entire team, especially the medical coders, to ensure accuracy and validity of every payment claim, and therefore, a secured Medicare reimbursement. The Centers for Medicare & Medicaid Services (CMS) runs the risk adjustment data validation ( RADV ) process to verify that the actual diagnosis codes applied and submitted for payment comply with the HCC coding guidelines and are supported by the appropriate medical health records. When done efficiently with a complete understanding of the HCC coding guidelines by medical coders, it directly influences the annual coverage amount for Medicare beneficiaries and minimizes losses for the organization.Īpproved CMS risk adjustment data validation (RADV) Beneficiary patients also benefit from this comprehensive process because they get a complete claim on their Medicare benefits and are assured of optimum treatment and care at all times.Īccurate identification of risks and appropriate RAF scoresĬomplete documentation of every case for each beneficiary using the MEAT criteria impacts the entire process, from the hierarchical condition category (HCC) medical coding using the ICD-10-CM code set to the accurate identification of risks based on diagnosis/diagnoses and to the assigning of the appropriate risk values or risk adjustment factor (RAF) scores. This is where the MEAT coding model of documentation comes in very handy as long as it is done accurately and completely by everyone on the team. Now, documentation is another ballgame that requires the same amount of dedication, which is why it should be done actively, effectively, and efficiently at all levels of monitoring and planning. ![]() As the physicians accomplish the updates, the risk adjustment and HCC process are also adjusted in real-time, and all relevant information is captured in the process. Management of chronic conditions is already a complex process for physicians because they need to update every so often in terms of diagnoses, symptoms, and new modes of treatment and procedures. Advantages of using the MEAT coding model:Įffective management of chronic conditions In this article, we will explore the MEAT coding model’s advantages and how it can help improve your organization’s HCC risk adjustment scores. ![]() We’ve discussed in our past blog how the MEAT (monitoring, evaluation, assessment, treatment) Criteria Model for coding is an excellent tool for monitoring key results and how it benefits partner organizations and stakeholders in achieving their business goals. ![]()
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