1. Risk Adjustment User Group
November 2008

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

3. INTRODUCTION

4. 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

5. 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.

6. PAYMENT PROCESS

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

8. DATA VALIDATION

9. DATA VALIDATION
Calendar Year 2007

10. RADV Calendar Year 2007 Pilot RADV Currently working on IVC review
SVC review is underway

11. 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

12. OPERATIONS UPDATES

13. 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.

14. TECHNICAL ASSISTANCE
UPDATES

15. TECHNICAL ASSISTANCE UPDATES
Next User Group Meeting
December 17, 2008

16. QUESTIONS & ANSWERS

17. CLOSING

18. RESOURCES
Sean Creighton (Director, Division Risk Adjustment Operations)
Henry Thomas (Training, Project Officer)
Louis Johnson (FERAS,GTL)
Lateefah Hughes (RADV)
LTC
CSSC