| Text of Recommendation | We recommend that Coventry Health Care of Missouri, Inc. enhance its compliance procedures to focus on diagnosis codes that are at high risk for being miscoded by 1) educating its providers about the proper use and documentation of these diagnoses and 2) determining whether these diagnosis codes (when submitted to CMS for use in CMS's risk adjustment program) comply with Federal requirements. |
|---|---|
| Recommendation Number | 271205 |
| Recommendation Status | Open |
| Significant Recommendation | No |
| Recommendation Questioned Costs | $0 |
| Recommendation Funds for Better Use | $0 |
| Submitting OIG | |
|---|---|
| Linked Report |