Designed to Amaze and Enlighten!
How many risk-codes are included in your patient’s capitation calculation each year.
A. The top four based on revenue generated.
B. the four most common.
C. 4 for ages 65-74, 6 for ages 75 and above.
D. Depends on why they enrolled in Medicare in the first place.
E. None of the above.
The startling answer below:
X
x
x
x
x
x
x
x
x
x
x
x
x
x
x
The answer is E. None of the above.
There is no limit to the number of chronic conditions that can figure into the monthly capitation calculation of a Medicare Advantage recipient. Some conditions cancel each other out, but there is no upper limit on the total.
My personal record is 17 in a patient with severe chronic illnesses who walked in off the street. Fortunately, s/he only needed my personal attention to set things right, but at first when he was very ill, I was well paid for my efforts.