Medicare Advantage and Prescription Drug Plans December 28 ...

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Plan Communications User Guide Appendices, Version 6.3 J.8 Part C Risk Adjustment Model Output Report Description This report shows the Hierarchical Condition Codes (HCCs) used by RAS to calculate risk adjustment factors for each beneficiary. Example Below is part of a Risk Adjustment Model Output report. The full report shows all of the Beneficiaries in the contract. 1***GROUP=H8888,CONTRACT=H8888, 1RUN DATE: 20031219 RISK ADJUSTMENT MODEL OUTPUT REPORT PAGE: 1 PAYMENT MONTH: 200401 PLAN: H8888 CHAMPION INSURANCE RAPMORP1 0 LAST FIRST DATE OF HIC NAME NAME I BIRTH SEX & AGE GROUP ------------ --------------- --------------- - -------- --------------- 123456789A WOOD CHARLES W 19250225 Male75-79 123456789B TREE LILLIAN L 19270418 Female75-79 123456789A GRASS ALBERT A 19421213 Male60-64 HCC DISEASE GROUPS: HCC019 Diabetes without Complication HCC080 Congestive Heart Failure HCC092 Specified Heart Arrhythmias INTERACTIONS: INTI01 DM_CHF December 28, 2012 J-21 Part C Risk Adjustment Model Output Report
Plan Communications User Guide Appendices, Version 6.3 J.9 RAS RxHCC Model Output Report - aka - Part D RA Model Output Report Description This report shows the Hierarchical Condition Codes (HCCs) used by RAS to calculate risk adjustment factors for each beneficiary. Example Below are the first few lines of a RA Model Output report. The full report shows all of the Beneficiaries in the contract. 1RUN DATE: 20060124 RISK ADJUSTMENT MODEL OUTPUT REPORT PAGE: 1 PAYMENT MONTH: 200602 PLAN: H9999 ACME INSURANCE COMPANY RAPMORP2 0 LAST FIRST DATE OF HIC NAME NAME I BIRTH SEX & AGE GROUP ------------ ---------------------------------------- ---------------------------------- - -------- --------------- 123456789A TWO RUTH M 19181122 Female85-89 RXHCC DISEASE GROUPS: RXHCC019 Disorders of Lipoid Metabolism RXHCC048 Other Musculoskeletal and Connective Tissue Disorders RXHCC092 Acute Myocardial Infarction and Unstable Angina RXHCC098 Hypertensive Heart Disease or Hypertension RXHCC159 Cellulitis, Local Skin Infection 123456789A BREEZE WINDY T 19620730 Female35-44 RXHCC DISEASE GROUPS: RXHCC045 Disorders of the Vertebrae and Spinal Discs RXHCC085 Migraine Headaches RXHCC098 Hypertensive Heart Disease or Hypertension RXHCC113 Acute Bronchitis and Congenital Lung/Respiratory Anomaly RXHCC129 Other Diseases of Upper Respiratory System RXHCC144 Vaginal and Cervical Diseases December 28, 2012 J-22 RAS RxHCC Model Output Report aka Part D Risk Adjustment Model Output Report
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Medicare Advantage and Prescription Drug Plans December 28 ...

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