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RISK ADJUSTMENT FACTOR (RAF) MADE EASY: PROVIDER HANDBOOK
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About RISK ADJUSTMENT FACTOR (RAF) MADE EASY: PROVIDER
Providers have been counseled to code “to the highest specificity,” yet are not taught how to accomplish it. Already overworked and often underpaid the Provider doesn’t have time to plow through all the rules and regulations to produce the solution. Risk Adjustment Factor Made Easy hopes to cut through the jungle of red-tape, thick textbooks, and laborious internet searches to equip the Provider with quick access to the knowledge needed to be successful while providing references on topics for more exploration when desired. In this version of the Hierarchical Condition Coding (HCC) and Risk-Adjustment Factor (RAF) coding book, the busy provider will receive a simple short-cut to all the information necessary to be successful. This book is quick; easy-to-understand; focuses on common mistakes made by Providers and displays examples of proper coding with appropriate details to help the Provider describe the illnesses of their patients more effectively.HCC/RAF is designed to estimate a patient’s "future" health care costs. With the changing of the payment system for Providers from “Paid for Services Rendered” to “Risk-Adjustment Value-Based Care” adherence to coding guidelines are vital to a Provider’s bottom line. With the coding details listed, you will learn which codes carry high value and why the codes currently used are not increasing your risk score; thereby, lowering potential earnings. The business end of the practice often suffers because of simple coding errors. This RAF book will arm the provider with the tools necessary to ensure success in the “Value-Based Care” system. ABOUT THE AUTHOR: Barbara Jane Deaton, MSN, FNP-BC, ENP-BCBarbara holds a Master of Science in Nursing and is dually certified as a Family Nurse Practitioner and an Emergency Nurse Practitioner. She owns her own practice in North Carolina and is deeply involved in Risk Adjustment Factor Coding. She has been recognized by a major insurance agency for her understanding of the Risk Adjustment Factor and its role in the future of medicine. Her own risk score has significantly increased by implementing the rules contained in this book.Barbara has won numerous awards since entering the medical field. Among her awards are “Best Nurse Practitioner Award in Morganton, NC 2018” for Inclusion in the 2019-2020 Edition of Worldwide Leaders in Healthcare: nominated Best Nurse Practitioner Preceptor 2019 by Perdue University: Business of the Year Award in Burke County, NC Foundation Award; and the Emergency Physicians Award by the United States Commerce Association.NOTE FROM THE AUTHOR:Over the past year, as I became more interested in the Risk Adjustment Factor (RAF), I realized that much of my research portrayed RAF as complex and extremely difficult to learn. When I began putting RAF into play in my own practice, I realized that as a Family Provider, the main codes continued to reappear. The techniques developed became second nature. Gifted with the ability to translate complex medical problems into simple language for some of my uneducated patients; I became aware that this gift should be used to break down the barriers that exist with Risk Adjustment Factor Coding. This book is written in a simplified format with characterizations to help get the point across. By placing these techniques into practice, the patient’s illnesses will be accurately portrayed, and the Provider’s bottom line will improve.
