Overview

"There is a common perception that Medicare Risk Adjustment (MRA) is all about the money. Is it? It always does come down to the money, but the managed-care MRA model is vastly different from the Fee for Service (FFS) model; the reasons that it is about the money are also different. The MRA model creates an interesting and significantly satisfying outcome for those who understand the system's whys and wherefores. This high-level look at MRA is written from ""The School of Hard Knocks""; distilling over twenty years of experience in the managed-care arena, from the ground-realities of caring for Medicare patients while juggling all the compliance issues surrounding the funding for that care."

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9781954261006

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Pariksith Singh, MD, is a practicing physician of 30 years. Board Certified in Internal Medicine, he believes unsettling changes in the healthcare industry can also be transformative. Dr. Singh watched his organization, Access Health Care Physicians, LLC, grow from a simple, multi-service provider in 2001 to one that has multiplied in size and is now respected throughout the state of Florida. In addition to heading this leading IPA, he has started a healthcare HMO, an ACO, and created one of the best health care corporate infrastructures in the business.Dr. Singh also finds time to be a published poet, philosopher and author. His medical contributions include a number of books. Dr. Singh and his wife, Maria Scunziano-Singh, MD, dedicate a large part of their lives to philanthropic endeavors and are passionate about supporting many different causes, especially veterans' welfare. Lynda Dilts-Benson, RN, CCM, LHRM, is the Education Director/Risk Adjustment Provider Educator for Access Health Care Physicians. As a nurse who was trained in coding and compliant documentation many years ago, she has witnessed and participated in the evolution of the healthcare coding and reimbursement models over time. Her extensive boots-on-the-ground experience in the healthcare industry, where documentation, coding, and compliance meet, has provided the insights and passion to share this knowledge with providers and staff so that they may succeed, while maintaining compliance in the vibrant and growing healthcare practice in which she works.

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