Although we are all in the health-care field, there is significant variance between the clinical and the coding worlds. Providers are not coders, which can result in documentation that can be referred to as “doctor-speak,” not “coding-speak.” Understandably, this difference can cause confusion, such as when inconsistencies regarding diagnosing current and historical conditions occur in the medical record. It is a longstanding practice for providers to use ‘History of’ when referring to a patient’s past conditions, whether they be…
Category Archives: "Newsletter"
Dr. David Wensel of Midland Care Receives Richard O. Schamp, MD, Award
MOORESTOWN, N.J., December 19, 2018 – Capstone Performance Systems, a subsidiary of Tabula Rasa HealthCare, Inc. (“TRHC”) (NASDAQ: TRHC), recognized David D. Wensel, DO, Chief Medical Officer of Midland Care in Topeka, Kansas, with the inaugural Richard O. Schamp, MD, Award. The Award is named in honor of Dr. Schamp, the founding CEO and visionary of Capstone Performance Systems, which provides expert Medicare risk adjustment, health plan management, and PACE operational consulting services to Programs of All-inclusive Care for…
Remarks of Dr. Richard O. Schamp at the CareVention HealthCare PACE Appreciation Dinner
Those who know me well realize how much a certain part of me would rather be anywhere else now, doing almost anything else. Yet, another part of me realizes that what we celebrate tonight is larger than my or Dr. Wensel’s accomplishments. Indeed, we celebrate the callings and service by hundreds of PACE medical professionals, executives and other leaders. These work tirelessly to deliver and improve care to vulnerable and complex patients and caregivers. Dr. Wensel is the proverbial…
Dr. Indira Kanouka Joins Capstone Performance Systems’ Consulting Team
Indira Kanouka, MD
Indira Kanouka, MD, has joined Capstone Performance Systems’ consulting team. A private practice physician in New Jersey, Dr. Kanouka had previously served as medical director of Beacon of Life, a PACE (Program of All-inclusive Care for the Elderly) organization, and of Specialty Hospital of Central Jersey.
Dr. Kanouka has extensive experience working with the geriatric population,…
Kim Browning Joins TRHC and Capstone Performance Systems
Kim Browning, CHC, PMP, has joined Tabula Rasa HealthCare (TRHC) as Executive Vice President (EVP) responsible for subsidiary company Capstone Performance Systems and its new division, Peak Health Plan Management, which resulted from Capstone’s recent acquisition of Peak PACE Solutions, an Altitude Edge company.
Kim Browning
Most recently, Ms. Browning was EVP of Cognisight, LLC, in…
Capstone Announces Leadership Changes
After more than 30 years in the field of geriatric care, including more than 15 years focusing on PACE (Programs for All-inclusive Care for the Elderly), Capstone Performance Systems founding CEO Richard Schamp, MD, has announced he is turning over the reigns of the company to colleague Kim Browning. After a short break, Dr. Schamp will provide broader leadership support through Tabula Rasa HealthCare (TRHC), Capstone’s parent company.
In the past year, Capstone’s leadership team has taken steps to prepare for…
Peak PACE Solutions is Now Part of Capstone
On May 1, Tabula Rasa HealthCare (TRHC), parent company of Capstone Performance Systems, acquired Peak PACE Solutions from Altitude Edge (AE), following the news of AE founders’ David Reyes and Ronda Hackbart retirements. Peak PACE Solutions is now Peak Health Plan Management Services and will operate as a service of Capstone.
“Capstone’s mission is to help our client organizations succeed fiscally in a compliant manner,” said Capstone CEO Richard Schamp, MD. “Having worked collaboratively for years with Peak, we look…
CMS Notifying PACE Plans of Next Round of 1/3 Part D Financial Audits
By Matt Zimmerman
Director of Client Success/Part D Consultant
It’s that time of year again! We have been advised that CMS is in the process of notifying PACE plans of their selection for the next round of 1/3 Part D Financial Audits. Selected plans will receive a notice from the CPA contracted to conduct this year’s audits shortly. If your plan is selected for this round of Part D financial audits, the audit team will be focusing on Payment Year 2017….
Documenting Major Depressive Disorder
By Denise Wills, CPC-A
When documenting depression, accuracy is important in determining the most specific code. If incomplete documentation is received, it will result in an unspecified code selection, which does not map to an HCC. For example, ICD-10 code F32.9 (MDD, single episode, unspecified) does not map to an HCC, whereas F32.0 (MDD, single episode, mild) does.
The ICD-10 classification of Mental and Behavioral Disorders, developed in part by the American Psychiatric Association, classifies depression by code. Documentation of Major…
Progress Notes: Provider Education and Support
By Richard Schamp, MD
CEO
Richard Schamp, MD, CEO
In our last edition, I mentioned the burgeoning new competency for physicians and other clinical providers – clinical documentation excellence. Let’s delve further into some specifics around the kinds of competence required in a risk-adjusted payment model. CMS has a process to verify that diagnosis codes reported that are relevant for payments in the HCC (Hierarchical Condition…