Clinical Documentation
For Medicare Advantage Plan Members
Martin’s Point values the role that high-quality primary care plays in the health of our community. As part of this primary care, the yearly assessment and documentation of chronic conditions—and the provision of that documentation to the Centers for Medicare and Medicaid Services (CMS)—is one of the most important ways providers and health plans can work together to support the health of our senior patients/members. Here’s why:
- These efforts assure that we can identify those patients/members who would benefit from the resources our Generations Advantage plans provide to support quality health care and improved outcomes; and
- These efforts also ensure compliance with CMS regulations for Medicare Advantage plans that require us to annually provide complete medical documentation of all current conditions affecting the treatment or management of care in order to accurately reflect the complexity and severity of an individual plan member’s health status. CMS requires this information to inform its risk adjustment process—its method for projecting the cost of care for each Medicare Advantage plan member.
Click on the link below for a brief description of the efforts we engage in to support our network providers and facilitate the accurate coding of your patients’ conditions. You can also read more about Medicare risk adjustment here.
For more information on these efforts or if you would like to schedule an educational session for your practice, please contact us at [email protected] or call us at 1-800-348-9804.
Additional questions? Read more in the Provider Manual or Contact Us.