Highmark will pay up to $5.5M for improved diagnostic documentation

Highmark has set aside up to $5.5 million to compensate Pennsylvania primary care physicians who improve how they identify, assess, document and report diagnosis codes for Medicare Advantage and Affordable Care Act health plan members. The Pittsburgh-based insurer has compensated providers in the past for confirming and documenting patient diagnoses, but says its latest efforts make more funding available for doctors who accurately complete documentation for a higher percentage of their patient base.

"This effort compensates doctors who are working with our members in government-focused programs, ties our reimbursement to high-quality care and allows us to better serve some of our most vulnerable patients with care management and coaching," according to Highmark Vice President and Medical Director Amy Fahrenkopf, M.D. Announcement