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The data is waiting in your next monthly file This user guide is a comprehensive reference manual for using the risk adjustment model output report (mor) that is provided by the centers for medicare & medicaid services (cms). At healthdatamax, we help maos automate, decode, and act on mor data—turning compliance requirements into revenue opportunities.

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Within the data files, there are model output reports (mors) with unique record types that correspond to each model being run for payment It ensures that health plans have visibility into how cms interpreted their data submissions and provides transparency into the risk model output. We distribute these mors to plans to identify the hierarchical condition codes (hccs) used to calculate risk scores for each of their enrolled beneficiaries.

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We’ve got a bag full of tips and tricks to set you up on the path to a successful mor

We’ll go over some common findings and how to avoid them as well as suggestions on how to better organize your tenant files for smoother audits. This new resource provides an overview of the mor, how to access mor files, a review of the format of the mor, instructions on how to read a mor file, a description of the data fields, and examples of the mor pdf and mor data file record types. At the heart of cms’s risk adjustment process lies the model output report (mor) This document is a vital feedback mechanism that informs medicare advantage organizations (maos) how cms is interpreting submitted diagnosis data and applying it to calculate risk scores.

The mor data file contains the same information as the mor pdf and consists of a header, detail section and a trailer record It is a flat file that enables automated processing. This report serves a dual purpose Supporting operational insight and enabling data validation