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The Capstone Performance Systems team is ready to assist your organization with services that improve documentation, support compliance, and optimize revenues. Check our conference schedule (below) to see when we might have an opportunity to meet with you or contact us at [email protected] to arrange a meeting or call.
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Risk Adjustment Advisor: September-October 2017
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Richard Schamp, MD Chief Executive Officer
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Capstone is pleased to continue our growth and to support to PACE and other organizations providing care to vulnerable citizens. To better serve our clients, we have recently welcomed several new staff members to the Capstone team with a wealth of experience directly relevant to the needs of our clients. See the article below for more details about our new colleagues. Additionally, be on the lookout for announcements in the coming months as we expand our services designed to support client success. We are proud to be rolling out our Client Success System during the next quarter; be sure to stop by our booth (#12) at the NPA Annual Conference to learn more about how we are aligning resources to improve service delivery.
If your PACE organization is selected in the current round of 1/3 financial audits, and you'd like expert assistance in preparing for that audit, contact us - we can help. At the very least, come to Matt Zimmerman's presentation Ten Easy Steps to Part D Compliance at the NPA conference. He'll be co-presenting with a few of our clients who have been down that road, so great insights will be offered. See the Conference Notes section below for more details.
October brings the final uphill climb in 2017 for your plan or provider group to achieve the risk scores needed to effectively serve your patients in future years. Be sure to get comprehensive assessments documented on all your participants before December 31. But even with good documentation, we too often see data leaks, leading to lower risk scores and lost revenue. Continuous oversight and management of encounter and RAPS data at every handoff between your providers and CMS is critical to your success. At the very least, plans must monitor the process of comparing inbound encounter and RAPS data submissions to the outbound results.
Capstone's software and services can examine multiple points in your data flow to help identify the hidden reasons why data leaks out of your pipeline. Ask us about a Coding Data Integrity Audit for your PACE organization.
Richard Schamp, MD
Chief Executive Officer
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Regional Training Sessions in Michigan and North Carolina
In
 August, Capstone Performance Systems held our first Regional Risk Adjustment training for our nine Michigan clients. The training was held at two locations within the state. A collaborative effort with the PACE Association of Michigan, the day-long training included morning sessions devoted to basic training, with Clinical Documentation Excellence covered in the afternoons. Chief medical officer George "Mike" Brett, M.D., and senior medical consultant David Wilner, MD, led the training along with risk adjustment and coding specialists Tiffany Brookshire, CRN-C and Jan Deyber, CRN-C. A second collaborative project is set for November with a two-day Primary Care training event in Lansing.
On November 2,
Capstone Performance Systems
and sister-company CareKinesis PACE Pharmacy will co-host Medication Safety: Hot Topics for PACE in Cary, NC. The free, CE credit event will include sessions on Community Acquired Pneumonia and Vaccinations; Ophthalmology Disorders; and De-prescribing for Safe Geriatric Pharmacotherapy, as well as a special session on opioids. David Wilner, MD, will
co-present three of the sessions with Kevin Bain, PharmD, and David McGain, PharmD, of CareKinesis. More information and registration is available
here
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Documentation Dispatch:
The World of ICD-10 Coding for Asthma
By Debra Byble, CPC, CRC
When ICD-10-CM was implemented, it was no longer necessary to code for the difference between extrinsic or intrinsic asthma. Found in section J45 of ICD-10-CM, asthma now requires documentation of mild, medium, or severe. Further documentation is needed to assign the correct code between the differences of intermittent, and persistent. The greater specificity of ICD-10-CM requires another level of detail: uncomplicated, (acute) exacerbation, and status asthmaticus.
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STAFF NOTES:
Capstone Welcomes New Staff
Capstone Performance Systems recently added several new staff members to our roster. In addition to
John Stolze
, senior vice president for business success, we welcomed
Wendy Myers, CRN-C
, risk adjustment and coding specialist. Wendy joined Capstone from West Virginia University of Medicine, where she was the lead RN for Vascular Surgery. In addition to being a certified RN-coder, Wendy holds certifications as a perioperative nurse (CNOR) and a surgical technologist (CST). She has an A.S. in Nursing from Washington Health System School of Nursing, an A.S. in Surgical Technology from the Pittsburgh Technical Institute, and an A.S. in Medical Information Processing from the West Virginia Career Institute.
Three new risk adjustment coders have also come onboard. Jacqui DeWitt, CPC, holds a medical coder certification from Pennsylvania Highlands Community College and an A.A.S. from Westmoreland Community College. Prior to joining Capstone, she was a coding consultant for Inovalon and a certified nursing assistant for Latrobe Health and Rehabilitation Center in Latrobe, Pa. Christy Lesko, CPC, previously served as an outpatient medical coder for Washington Health System-Greene in Waynesburg, Pa. She received her training and certification in medical coding from the American Academy of Professional Coders and holds a B.S. in Graphic Communications Technology from the California University of Pennsylvania. Rita Weaver, CPC, most recently served as a claims examiner for health plan services and prior to that as a claims customer service representative for Liberty Mutual Insurance Co. She received her training and certification in medical coding from the American Academy of Professional Coders.
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Fall 2017: Upcoming Conferences & Meetings
With the onset of fall comes cooler weather - and several opportunities to see our old friends and clients and to meet new ones. If you are planning to attend any of the following meetings, please visit us!
AAHCM Annual Meeting
, October 13 - 14
Lowes Chicago O'Hare, Rosemont, IL - Booth #26
National PACE Association Annual Conference
, October 15 - 18
Westin Waterfront Hotel, Boston, Mass. - Booth #12.
Come to the Massachusetts PACE Association's Welcome Reception on Sunday, October 15, which we are co-sponsoring with CareKinesis, and join us immediately following for a PACE Appreciation Dinner, co-hosted by Capstone and CareKinesis. Details and registration are available
here
. During the conference, Capstone professionals will co-present the following sessions:
50 Tips in 50 Minutes: Operational Tactics to Optimize Clinical Documentation, RAPS Data and Risk Scores
(George "Mike" Brett, MD, chief medical officer, and David Wilner, MD, senior medical consultant, co-presenting with Lori Pigeon, NP, Harbor Health Elder Service Plan); Monday, October 16, 10 am
Ten Easy Steps to Part D Compliance and Tales from the Dark Side:
Real-Life PACE Plan Audit Experiences
(Matt Zimmerman, director of client success & risk adjustment consultant, co-presenting with Deborah Quillen, BA, CareKinesis, Inc.; Amanda Boyle, BSW, Immanuel Pathways; Bushra Hashmi, MHSA, MBBS, Midland CareConnection; and Thelma Pittman-Alderson, MBA, Cherokee Elder Care); Tuesday, October 17, 8 am
CalPACE Member Dinner and Affiliate Meet & Greet
, November 14 - 15, Sacramento, CA
Capstone is sponsoring the member dinner and participating in the Meet & Greet the following day.
Be sure to visit us at our exhibit booth if you are attending these events! If you would like to arrange a private meeting to discuss how we can help your organization ensure compliance and optimize revenues, email
[email protected]
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LAST CHANCE TO REGISTER: Registration for the PACE Appreciation Dinner at the NPA conference has been extended! The final day to register is October 12, 2017!
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Clinical Documentation Excellence (CDE) Bulletin
Capstone Performance System's
Clinical Documentation Excellence (CDE) Bulletin, is a monthly e-bulletin with topics relevant to Primary Care Providers. Information typically includes clinical background, diagnosis tips, documentation requirements and ICD-10 coding guidance. Each month, the
CDE Bulletin focuses on
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PACE industry
information, and more!
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