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Risk Settings

Julie Glass
Modified on: Wed, 12 Oct, 2022 at 9:27 AM

Access Risk Settings

1. To access your Risk Settings go to: Admin > Projects
2. Select desired project
3. Click Risk Settings


Here is where you define your review period and overread settings for your Risk project.

Risk Settings Page Overview

  1. Review Period: This is the review period of your project. This information cannot be edited 
  2. Document Review Level: 
    1. If a project is configured to ‘Member Validation’ for the document review level, a user will be prompted to verify that the member is correct.
    2. If a project is configured to ‘Member and DOS Validation’ for the document review level, users will be asked to perform a more thorough review of the document once the member has been validated. For each date of service that was loaded for a given chase, the user will be asked to select either ‘Yes’ or ‘No’ to indicate whether that specific date of service is present. If the DOS is present, they will also be prompted to indicate whether the provider signature for that date of service is present.
  3. Coding Level: Here you choose Full Coding or Diagnosis only    
  4. HCC Model if applicable, cannot be edited.
  5. Omission Codes: Toggle to enable the allowance of omission codes to be added during review. 
  6. Overread Feedback: Displays all Chases that have Coder, Overreader and Manager to review Overread Feedback and Feedback Challenges.
  7. Overread Settings: Define Overread percentages
  8. Overread 2 Settings: Define Overread 2 percentages
  9. Provider requirements: Decide if provider must be included in validation process
  10. VRC requirements: Decide if VRC must be included in validation process
  11. Service Type: Decide if service type must be included in validation process

 




 

 

Note: 
 * If deficient chase values are set to anything less than 100%, some pursuits will not get generated and there is a chance invalid chases will be submitted to delivery.

 

User Permissions
 User Permissions: Administrator 

 

 


 

 


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