Risk Adjustment User Group November 2008

Welcome to the November User Group Introduction Payment Process Operations Update Data Validation Questions and Answers Closing

INTRODUCTION

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

PAYMENT PROCESS Final Reconciliation Due Date 1/31/2009 Dates of Service (1/1/07 – 12/31/07)

DATA VALIDATION

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 UPDATES

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

QUESTIONS & ANSWERS

CLOSING

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