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2006/2007 Monthly

2006/2007 Monthly. Risk Adjustment User Group Session. A training initiative presented by. JULY 2007. Welcome to the July User Group. Introduction Payment Process Data Validation Operations Update Training Update Questions and Answers Closing. INTRODUCTION. Introduction.

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2006/2007 Monthly

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  1. 2006/2007 Monthly Risk Adjustment User Group Session A training initiative presented by JULY 2007

  2. Welcome to the July User Group • Introduction • Payment Process • Data Validation • Operations Update • Training Update • Questions and Answers • Closing

  3. INTRODUCTION

  4. Introduction User Group Process • All attendees must pre-register • Panel will answer questions during the Q&A portion of the session • Session will last for one hour • Q&A document and session notes will be available within 2 weeks after the session • Session slides will be available by the Tuesday before the session

  5. PAYMENT PROCESS

  6. Payment Process • 2006 final scheduled for August payment • Final 2006 and mid-year 2007 Model Output Reports (MOR) to be available mid-August • 2004 and 2005 MORs to be available on July 26, 2007 • 2005 and 2006 ESRD reconciliation -- CMS testing ESRD status

  7. DATA VALIDATION

  8. Data Validation • Calendar Year 2006 • May 31, 2007: Notification letter distributed to selected MA organizations • June 29, 2007: Instructions package sent to selected MA organizations • July 11, 2007: Teleconference to orient selected MA organizations to RADV process • August 17, 2007: Medical record submission deadline

  9. Data Validation • Calendar Year 2005 • Second validation contractor (SVC) currently reviewing medical records – expected to conclude this month • Organizations contacted by CMS to confirm provider credentials – responses required by COB on July 23, 2007 • CMS anticipates releasing results in the fall of 2007

  10. Data Validation • Calendar Year 2004 • QA process completed • July 12, 2007: Plan-specific findings disseminated • August 2007: Teleconference with MA organizations to communicate results

  11. OPERATIONS UPDATE

  12. 502 DUPLICATE STATUS

  13. TRAINING UPDATE

  14. Training Update 2007 Regional Training Schedule* • August 7 – 9, 2007 • Las Vegas, NV • Register online at • www.medicaretraining.net • *Risk Adjustment session is closed

  15. Training Update 2007 Monthly Training Schedule* Monthly training sessions will be available for September and October *Register online at www.medicaretraining.net

  16. QUESTIONS AND ANSWERS

  17. CLOSING

  18. Resources • Sean Creighton (Director, Division Risk Adjustment Operations) • sean.creighton@cms.hhs.gov • Henry Thomas (Training, Project Officer) henry.thomas@cms.hhs.gov • Lateefah Hughes (Data Validation, Team Lead) lateefah.hughes@cms.hhs.gov • Louis Johnson (FERAS, Risk Adjustment Coordination) louis.johnson@cms.hhs.gov • Chanda McNeal (Payment Issues) chanda.mcneal@cms.hhs.gov • LTC www.Medicaretraining.net • CSSC www.csscoperations.com

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