Top 30 Diagnosis a physician bills

What: Being able to see the most common 30 diagnosis codes a physician uses for all diagnosis billed by this doc (not just primary diagnosis)

Why: If a physician has any unspecified diagnosis as their most common, this means the physician doesn't do a good job at coding and there's area for improvement. It's easier for an ACO or MA Health plan to fix coding problems to increase revenue than to fix clinical and population issues. Knowing this data will show them if the physicians/physician group is a good target or not to increase the HCC risk score.

Purpose of looking at ALL dx billed is because if a patient has multiple co-morbidities we need to see all the dx because they all matter (not just primary and because the primary could be something acute like cough). This is to capture the chronic conditions

Who: ACO's and MA Plans

Who Requested: Mike B at Wellcare

When: High Priority

Revenue Tied to This: Wellcare ($140K)

Competitor’s that have this: I think CareJourney has something very similar. Please verify with Mike or Dr. Serota at Bright Health