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The Top 9 Questions Every Medical Coder Asks about Risk Adjustment and the CRC Certification

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The Top 9 Questions Every Medical Coder Asks About Risk Adjustment and the CRC™ Certification was presented in a webinar by Certification Coaching Org (CCO), www.cco.us. A wealth of information was covered including: what Risk Adjustment (RA) entails, how this field is growing, and RA career opportunities. Also discussed was what to look for in a Risk Adjustment course. Attendees’ questions on careers in RA or preparing for the Certified Risk Adjustment Coder (CRC™) credentialing examination were answered. Presenters were Alicia Scott, CPC, CPC-I, CRC, and Chandra Stephenson, CPC, CIC, COC, CPB, CPCO, CPMA, CPC-I, CCS, CANPC, CEMC, CFPC, CIMC, CGSC, COSC, CRC, CCC. The host for the webinar was Boyd Staszewski.

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The Top 9 Questions Every Medical Coder Asks about Risk Adjustment and the CRC Certification

  1. 1. The Top 9 Questions Every Medical Coder Asks about Risk Adjustment and the CRC™ Certification
  2. 2. The Top 9 Questions about Risk Adjustment and the CRC™ Certification Polls *Are You Certified? * What is your interest level in the CRC™ certification?
  3. 3. The Top 9 Questions about Risk Adjustment and the CRC™ Certification Chandra Stephenson CPC, CIC, COC, CPB, CPCO, CPMA, CPC-I, CCS, CANPC, CEMC, CFPC, CIMC, CGSC, COSC, CRC, CCC CCO Program Director Alicia Scott CPC, CPC-I, CRC CCO Education Director
  4. 4. Alicia Scott CPC, CPC-I, CRC CCO Education Director ● Worked in the medical field for 26 years ● CCO Education Director ● CCO Student Coach ● CCO Risk Adjustment Course Developer and Instructor ● Known as the “ICD-10 CM Guru” of CCO ● Created and presented two ICD-10-CM Courses for CCO: - "ICD-10-CM (Diagnostic) Full Course"- 80 hours - “ICD-10-PCS (Procedural Coding System) Training Course” ● Specialist in Diagnostic Coding and HCC Risk Adjustment ● Working towards Masters Degree in Health Care Administration ● Passion for education ● Pastors Wife with 6 Children (10-28) | Married 29 years ● Never had a cavity :) Who is Alicia Scott ?
  5. 5. Who is Chandra Stephenson ? Chandra Stephenson CPC, CIC, COC, CPB, CPCO,CPMA, CPC-I, CCS, CANPC, CEMC, CFPC, CIMC, CGSC, COSC, CRC, CCC CCO Program Director ● CCO Program Director ● CCO Risk Adjustment Course Developer and Instructor ● CCO Student Coach ● National ICD-10 Trainer for AAPC ● Representative for the Great Lakes Region on the AAPC's 2013-2015 National Advisory Board. ● Extensive experience in centralized billing, family practice, cardiology, GI, mental health, anesthesia, and multi-specialty environments. ● Adjunct college instructor in medical coding ● Compliance auditor for one of the largest healthcare systems in Indiana |Big 5 consultant ● Currently an independent consultant and enjoys finding ways to simplify the world of coding accuracy and education. ● Holds a CRC credential along with: CPC, CIC, COC, CPB, CPCO, CPMA, CPC-I, CCS, CANPC, CEMC, CFPC, CIMC, CGSC, COSC, and CCC ● Chandra has over 13 years coding and auditing experience
  6. 6. The Top 9 Questions about Risk Adjustment and the CRC™ Certification
  7. 7. What We’ll Cover 1. Short History and Explanation of Risk Adjustment Coding 2. Is the demand for risk adjustment coding and a CRC™ credential increasing? What’s the BUZZ around CRC™? 3. Does a CRC™ certification result in a higher salary? 4. Does a CRC™ credential make you more employable? 5. Does the CRC™ designation only include HCC risk adjustment coding? Only Medicare? 6. Is RA seasonal coding? 7. Do you need to be a CPC® certified coder first? 8. What about ICD-10 in RA? 9. Is there more to just RA than coding? 10.How much auditing is needed for RA?
  8. 8. Short History and Explanation of Risk Adjustment Coding ●What risk adjustment (RA) is –The purpose of RA –Where RA originated –Which plans are RA plans ●Why understanding RA coding is essential ●How RA differs from traditional coding ●Why there are an increasing number of RA plans
  9. 9. Is the demand for risk adjustment coding and a CRC™ credential increasing?
  10. 10. Does a CRC™ certification result in a higher salary?
  11. 11. Does the CRC designation only include HCC risk adjustment coding? Only Medicare? No, the CRC™ certification exam includes questions on all areas of risk adjustment, including the different methodologies: ● Medicare Part C (CMS HCC) ● Medicare Part D (CMS RxHCC) ● Medicaid (CDPS) ● ACA Marketplace Plans (HHS HCC)
  12. 12. Is Risk Adjustment Coding Seasonal in Demand? Risk Adjustment work is full time, year round. There is reason some people think it is seasonal. ● Three pulls a year ● MA plans that work with contracts ● Hiring policies RA jobs have changed in the past few years ● Not just MA plans risk adjust ● Greater demand for RA coding
  13. 13. Do You Need to be a CPC® Certified Coder Before CRC™ ? Alicia’s Point of View Chandra’s Point of View You must have a thorough knowledge of coding. Confidence in abstraction Quality vs. Quantity - 98% Have to love ICD-10-CM Great starting point in the field if you are willing to learn Requires willingness to ask questions and ability to research
  14. 14. What about ICD-10 in Risk Adjustment? That is what it is all about! ● ICD-10-CM is diagnosis coding. ● Language of risk adjustment ● Capturing illnesses that risk adjust ● Chronic disease
  15. 15. Is There More to Risk Adjustment Than Just Coding? Yes! ● Different RA Plan types and components ● Record reviews, audits, and data submission requirements ● Risk score calculations ● Quality care impacts (STAR, HEDIS) ● Documentation improvement ● Communication
  16. 16. How Much Auditing Knowledge is Needed for Risk Adjustment Coding? Identify problems in a medical encounter is what an auditor does. ● Understand clinical documentation ● Understand the disease process to back up a code choice ● Medical record format
  17. 17. Will the CRC™ Help You in Other Medical Coding Areas?
  18. 18. The Top 9 Questions about Risk Adjustment and the CRC™ Certification Polls * NOW what is your interest level in the CRC™ certification?
  19. 19. What things should you look for when when choosing a Risk Adjustment coding course? ● Are there testimonials from real students? ● Can I talk to previous students? ● Is this credential a good fit for me? ● Is the instructor certified? ● What is their goal? ● What is covered in the course? ● How much does it cost? ● How long does it take to complete the course? ● How long do I have access? ● Do I need to purchase books/manuals ● Is there a guarantee? ● Does it look to good to be true?
  20. 20. What We’ll Cover: Questions YOU Should be Asking 1. What things should you look for when choosing a Risk Adjustment coding course? 2. Will the CRC™ help you in other medical coding areas? 3. What other skills with Risk Adjustment coding help me improve? 4. What advantage will the CRC™ give me for career advancement? 5. BONUS: Your Questions in the Chat
  21. 21. The CCO Risk Adjustment 2.0 Course A Complete “No-Fluff” Course That Will Teach You The Core Essentials of Risk Adjustment AND Prepare You For The CRC™ Exam http://www.cco.us/rawebinar
  22. 22. The Top 9 Questions about Risk Adjustment and the CRC™ Certification * Who is the right kind of coder to start the CCO RA Course 2.0?
  23. 23. Risk Adjustment 2.0 Course Contents 40 Equivalent Hours http://www.cco.us/rawebinar
  24. 24. The CCO Proven Process
  25. 25. Testimonials and Reviews http://www.cco.us/testimonials/
  26. 26. Testimonials and Reviews https://www.facebook.com/cco.us/reviews
  27. 27. Questions In The Chat- RA Webinar Your Webinar Chat Team CHAT QUESTIONS
  28. 28. Is CRC better than CPMA? Question: I have a quick question, I'm currently studying for the CPMA test. Is the CRC better than the CPMA?
  29. 29. CRC before job as HCC Coder Question: Would it be better for me to get the CRC before I try to get a job as an HCC coder or get a job and the experience while I study for the exam? TIA :)
  30. 30. CRC and Specialties Question: I currently have CPC, CEDC and on 8/1 I am going to take my CRC. My employee originally told me they don't recognize the CEDC. How would CRC fit into specialty certifications.
  31. 31. Remote work for RA Question: How do I find a mentor to take me under their wing? I currently volunteer at my local hospital. Maybe there? AAPC local chapter member? I heard Alicia mention remote work for Risk Adjustment. I would very much need that due to a chronic medical condition. I know you can't start out in remote coding.
  32. 32. Pathophysiology and Pharmacology Question: Should you know pathophysiology for RA coding? What about pharmacology?
  33. 33. RA vs no Billing Background Question: Would you say it's easier for someone with a medical billing background to get into Risk Adjustment vs someone with no billing background?
  34. 34. CRC Work Question: Does CRC work on facility or Dr's office? If it works on facility charts, does it code separate with regular charts or does it together?
  35. 35. CRC™ Practice Exam Question Question: What does a CRC™ Exam Question look like? How do we work through an exam question? ANSWER Alicia Scott, CPC, CPC-I, CRC CCO Education Director
  36. 36. The Top 9 Questions about Risk Adjustment and the CRC™ Certification Need help? Not sure what to do next? Email: helpdesk@cco.us CALL US TOLL-FREE AT (877) 225-0713 or visit the CCO help desk at https://helpdesk.cco.us/support/home
  37. 37. Happy CRC™Coding!

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