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In the evolving landscape of Medicare, integrating health plan risk and revenue operations is crucial for success. This guide outlines ten transformative steps to break down silos and create a unified Medicare Advantage revenue management team. Discover strategies to engage physicians, leverage data optimization, link EMR systems, and enhance coding accuracy. By implementing internal audits and effective RADV strategies, organizations can improve performance, mitigate risks, and maximize revenue while ensuring compliance and stellar Star Ratings.
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10 Critical Steps to Integrate and Transform a Health Plan Risk Revenue Operation • 10 Critical Steps to Integrate and Transform Your Health Plan Risk Revenue Operations • Knock Down Silos to Build a Completely Integrated Medicare Advantage Revenue Management Team • Engage Physicians -- How to Leverage Medical Management Value from Prospective Assessments • Link EMR with Your Health Plan to Streamline Risk Revenue Management • Optimize Value of Prospective vs. Retrospective Data • Integrate Retro Chart Review with HEDIS • Mitigate Risk Adjustment Through Internal Audits and Other Trouble Shooting Strategies • Get Powerful Tools to Design an Effective RADV strategy • Track True Plan Performance • Improve Coding Accuracy: Best In Class ICD-10 and Encounter Data Practices • Integrate Risk and Quality to Maximize Revenue and Star Ratings
