Optimal Prospective Health Evaluations and Transitioning to Encounter Data Processing Systems Summit

Venue: The Sheraton Austin Hotel

Location: Austin, Texas, United States

Event Date/Time: Oct 04, 2012 End Date/Time: Oct 05, 2012
Registration Date: Oct 05, 2012
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On October 4th, we’ll look at how optimal design, implementation and integration of prospective health evaluations can impact much more than just your risk adjustment programs. Our speaking faculty will address:
-The what, why, and how of prospective evaluations: How plans are approaching prospective programs and what is working
-Best practices for streamlining at-risk members into your care management programs: Looking for the ‘hits’ through your HCC codes
-How prospective evaluations impact your 5-Star piece: HEDIS, CAHPS, Part D, and more!
-Getting member and provider compliance and buy-in with your prospective program
-Allocating the proper resources for your prospective program and measuring your ROI

On October 5th, we are moving beyond merely EDPS compliance and looking at what is really affected by the transition to Encounter Data, and what that means for the future of health plans: from audits to revenue to parallel submissions. Our experts will be looking at:
-What does CMS really want: Defining encounters, utilizing the data streams, and all the implementation updates
-Aligning your CPT-code filtering with CMS’s and best practices for rejections and corrections
-Changes in risk adjustment reimbursement under EDPS
-Delegating the increased workload that is coming out of the 837 format
-The real effect on your ROI: How does EDPS change the bottom dollar for risk adjustment and the way CMS views a member
-Utilizing EDPS for prospective chart reviews and the changing role of retrospective chart review


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