1. Risk Adjustment User Group Session
2006/2007 Monthly
Risk Adjustment User Group Session
A training initiative presented by
JULY 2007 1

2. Welcome to the July User Group
Introduction
Payment Process
Data Validation
Operations Update
Training Update
Questions and Answers
Closing 2

3. INTRODUCTION 3

4. Introduction User Group Process All attendees must pre-register
Panel will answer questions during the Q&A portion of the session
Session will last for one hour
Q&A document and session notes will be available within 2 weeks after the session
Session slides will be available by the Tuesday before the session 4

5. PAYMENT PROCESS 5

6. Payment Process 2006 final scheduled for August payment
Final 2006 and mid-year 2007 Model Output Reports (MOR) to be available mid-August
2004 and 2005 MORs to be available on July 26, 2007
2005 and 2006 ESRD reconciliation -- CMS testing ESRD status 6

7. DATA VALIDATION 7

8. Data Validation Calendar Year 2006
May 31, 2007: Notification letter distributed to selected MA organizations
June 29, 2007: Instructions package sent to selected MA organizations
July 11, 2007: Teleconference to orient selected MA organizations to RADV process
August 17, 2007: Medical record submission deadline 8

9. Data Validation Calendar Year 2005
Second validation contractor (SVC) currently reviewing medical records – expected to conclude this month
Organizations contacted by CMS to confirm provider credentials – responses required by COB on July 23, 2007
CMS anticipates releasing results in the fall of 2007 9

10. Data Validation Calendar Year 2004 QA process completed
July 12, 2007: Plan-specific findings disseminated
August 2007: Teleconference with MA organizations to communicate results 10

11. OPERATIONS UPDATE 11

12. 502 DUPLICATE STATUS 12

13. TRAINING UPDATE 13

14. 2007 Regional Training Schedule*
Training Update
2007 Regional Training Schedule*
August 7 – 9, 2007
Las Vegas, NV
Register online at
* Risk Adjustment session is closed 14

15. 2007 Monthly Training Schedule*
Training Update
2007 Monthly Training Schedule*
Monthly training sessions will be available for
September and October
*Register online at 15

16. QUESTIONS AND ANSWERS 16

17. CLOSING 17

18. Resources
Sean Creighton (Director, Division Risk Adjustment Operations)
Henry Thomas (Training, Project Officer)
Lateefah Hughes (Data Validation, Team Lead)
Louis Johnson (FERAS, Risk Adjustment Coordination)
Chanda McNeal (Payment Issues)
LTC
CSSC 18