
Risk Adjustment User Group November 2008
Welcome to the NovemberUser Group • Introduction • Payment Process • Operations Update • Data Validation • Questions and Answers • Closing
INTRODUCTION User Group Process • All attendees must pre-register • It is only necessary to register once • Retain unique PIN for all sessions • Session will last for one hour • Session slides will be available by the Tuesday before the session • Panel will answer questions during the Q&A portion of the session
INTRODUCTION • The 2008 monthly Risk Adjustment User Group Q & A and Notes documents are posted at the CSSC Operations website. • Please continue to review the website for updates to this information. www.csscoperations.com/new/usergroup/usergroupinfo.html
PAYMENT PROCESS Final Reconciliation • Due Date 1/31/2009 • Dates of Service (1/1/07 – 12/31/07)
DATA VALIDATION • Calendar Year 2007
RADV Calendar Year 2007 • Pilot RADV • Currently working on IVC review • SVC review is underway
RADV Calendar Year 2007 (cont’d) • Regular RADV • Sampling is underway • January 2006 through December 2006 dates of service will be reviewed • Enrollee sample will include beneficiaries who were in the selected contract from January 2006 through January 2007 • Targeted Plans • CMS’ contractor, HMS, distributed initial notification and request for medical record contact on Monday, November 10 • Reminder: Submit medical record contact information to HMS • Instructions Packet will be distributed shortly • Plans will be given 12 weeks to submit medical records
OPERATIONS CSSC Operations Holiday Closings: • Thursday, November 27th • Friday, November 28th Please note: • The Front-End Risk Adjustment System (FERAS) will be available during this time for RAPS submissions.
TECHNICAL ASSISTANCE UPDATES
TECHNICAL ASSISTANCE UPDATES Next User Group Meeting December 17, 2008
RESOURCES • Sean Creighton (Director, Division Risk Adjustment Operations) sean.creighton@cms.hhs.gov • Henry Thomas (Training, Project Officer) henry.thomas@cms.hhs.gov • Louis Johnson (FERAS,GTL) louis.johnson@cms.hhs.gov • Lateefah Hughes (RADV) lateefah.hughes@cms.hhs.gov • LTC www.tarsc.info • CSSC www.csscoperations.com