EmblemHealth’s risk adjustment program is designed to help our primary care providers (PCPs) identify members with chronic conditions who require an annual evaluation. The program also supports correct coding and documentation of the severity of the member’s condition.
We work with Veradigm (previously known as Pulse8) to capture the complete health status of each New York State of Health (NYSOH) Marketplace, Medicare HMO, and Medicaid member. We look to our PCPs to maintain accurate medical record documentation and claims coding and provide evidence of ongoing care to support accurate reimbursement from government programs.
As a bonus, PCPs who also complete a compliant provider alert and provide the supportive progress note(s) in Veradigm’s Collaborate Provider Portal can receive additional reimbursement.
The 2023 EmblemHealth Risk Adjustment Program for Primary Care Providers (PCPs) runs from Jan. 1, 2023, through Dec. 31, 2023.
Veradigm offers a series of free, 60-minute monthly webinars. Each session is followed by a question-and-answer period. You may register for the monthly webinars through the secure provider portal or on our website’s Learning Online Veradigm Webinar page.
The webinars are held on Tuesdays and Thursdays, with one session in the morning and one in the afternoon to accommodate all schedules. Here are the upcoming topics:
- March 28 and 30: The Ultimate Guide to Documentation and Coding.
- April 25 and 27: Don’t Be Fooled … Social Determinants of Health are Key Factors for Your Patient Population.*
- May 23 and 25: Blooming into the Comprehensive Evaluation of Neurological Disorders.
We encourage you and your staff to take advantage of this educational opportunity.
2023 Collaborate Provider Portal
PCPs can visit Veradigm’s Collaborate Provider Portal via the EmblemHealth provider portal. Collaborate is a web-based tool that supports improvements in documentation, quality, and risk score accuracy.
If you are interested in learning more about how you can view Veradigm’s provider resources and webinars, contact Veradigm’s Customer Support team Monday through Friday, 8 a.m. to 8 p.m., at 800-877-5678, option seven. Or, send an email to support@veradigm.com.
*You can also see our own medical director’s perspective on population health and the social determinants of health.
JP 61585 03/2023