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Welcome to Medicare Advantage Review Associates (MARA)
With costs rising and revenue sources diminishing, it is imperative that Health Plans and their risk partners identify their members' relative severity of illness - the key to Medicare's premium calculation. Accuracy in medical chart documentation is essential to proper and complete reimbursement for Medicare Advantage members Developed by a
team of experienced managed care executives and physicians, MARA uses its
Integrated Approach and Clinical Analytics software to:
Our proprietary HCCFIND software
integrates claims, encounter, and prescription drug data with
hundreds of special clinical algorithms to identify "high-yield"
charts, those charts most likely from a clinical and statistical
point of view to contain overlooked diagnoses or have been coded in
error (typically 30% to 40% of all records). HCCFIND prioritizes the
chart review list. By eliminating up to 2/3 of the charts, Clients
can choose the optimal point of their investment and maximize return
by greatly reducing the time and expense required to review charts.
With a focused and efficient chart review:
MDINFORM uses its own set of algorithms
to identify HCC's that are "not in the chart." Also integrating a
range of data form health plans and CMS, MDINFORM identifies
potential HCC's that are either:
After MDINFORM identifies those charts most likely to have documentation errors, nurses trained as clinical auditors use our MLP module to verify the diagnoses that have already been reported for the current year. Then, during the chart review process, the auditors use MLP to record opportunities to capture HCC diagnoses. These recommendations are printed out as clear, concise patient-specific bulletins. When combined with a physician's appointment schedule, these bulletins provide valuable suggestions to the doctor just in time for patients' visits. With our custom advisories, physicians can examine their patients and accurately document the chart in accordance with Medicare guidelines. In short, MARA's program provides busy doctors with helpful information they need at the time the need it, while teaching them correct documentation technique. With a faculty of experienced Health Care
professionals (including experienced coders, a Primary Care Physician, and a
Practice Management Consultant), MARA can provide Physician Education that
will result in complete and accurate coding.
Other Services:
MARA offers a range of services including data
acquisition, custom software reporting, chart review, and final reporting to
CMS. MARA also offers educational seminars for medical and coding staff and
consultation on data collection techniques in order to increase accuracy for
future claim submissions.
MARA takes the burden off clients and produces timely and valuable results. |
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Based
in Boston Massachusetts, MARA provides software-based solutions to
assist physicians and Health Plans in obtaining full premium revenue for
their Medicare Advantage members. MARA's goal is to help clients
achieve accurate and complete documentation, diagnosis coding and reporting
of their Medicare Advantage members' health status.