We recommend that Regence BlueCross BlueShield of Oregon continue to examine its existing compliance procedures to identify areas where improvements can be made to ensure that diagnosis codes that are at high risk for being miscoded comply with Federal requirements (when submitted to CMS for use in CMS's risk adjustment program) and take the necessary steps to enhance those procedures.
Questioned Costs
$0
Funds for Better Use
$0
Recommendation Status
Open
Source UUID
22-A-09-085-22-A-09-08503
Recommendation Number
22-A-09-08503
Significant Recommendation
No