Concern · Geographic area

Health risk-adjustment programme requirements

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Health risk-adjustment diagnosis and eligibility mappings

Which diagnosis codes, encounter classes, provider types, service dates, and participant categories are eligible and how do they map into the stated healthcare risk-adjustment model?

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Health risk-adjustment model factor and version rules

Which model segments, factors, interactions, hierarchy logic, normalization, and version rules apply to the stated healthcare risk-adjustment programme and payment year?

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Health risk-adjustment submission and deletion rules

What submission, evidence, attestation, deadline, correction, deletion, and audit rules govern the stated healthcare risk-adjustment programme?

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“health risk adjustment model rules”“risk adjustment diagnosis and submission requirements”

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