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Medicaid Risk Adjustment Records Review

Tracey Posted Tue 04th of June, 2013 16:48:12 PM

We recently received a letter from Altegra Health on Behalf of Amerigroup requesting the above mentioned. It does state that we have the option of declining to participate. Can you explain to me what this is and if you see a benefit to participating?

SuperCoder Answered Wed 05th of June, 2013 21:20:05 PM


We are very much working on this case and have consulted our editor for this to make sure you get the correct answer. He will work on this and get back to you soon.


SuperCoder Answered Wed 12th of June, 2013 22:01:00 PM

It's difficult to answer without knowing what the Medicaid payer is looking for. If they are gathering analytics to make benchmarks, many practices have no problem participating. But they will most likely tell you the reason they are performing the review up front. Share that information with your practice attorney to make a decision on whether to participate.

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