8 tips for a seamless commercial risk adjustment program

With the implementation of its payment transfer model, the U.S. Department of Health & Human Services (HHS), in conjunction with the Centers for Medicare & Medicaid Services (CMS), has defined how health plans should expect to conduct business when participating in the Health Insurance Marketplace. Understanding the complexities of the payment transfer model is key to succeeding as a Qualified Health Plan (QHP). In our latest checklist, we outline top tactics for QHPs looking to better understand and prepare for commercial risk adjustment success this year.

Download this asset to learn the value of:

  • Getting to know your population early on
  • Improving efficiency with the retrieval and coding of medical records
  • Scrubbing and quality-checking your data
  • Ensuring successful data submission
  • Analyzing final reports
  • And more

none none health-insurer none medicaid-agency no revenue-integrity none no commercial-risk-adjustment none none no none checklists no no no

view your checklist