Medical Risk Adjustment Toolkit

Social Determinants of Health Coding Reference Guide

SDOH is a tool to better understand population needs and provides an indirect way of looking at how costs impact care. Although these codes do not affect risk adjustment per se, they do help provide a comprehensive picture for providers and payors.



FAQ’s: Social Determinants of Health Questionnaire

1. Why must I address social determinants of health status codes during patient encounters?
In an attempt to gauge social and economic patient barriers to receiving care, this information will help ensure each patient’s risk adjustment factor (RAF) aligns and provides necessary health plan resources, improving value-based care.

2. How often do we update coding in the patient’s medical chart?
Annually or if the patient’s situation has changed.

3. Do I have to address all questions during every patient encounter?
To get a complete picture of each patient’s social and economic determinants of health, it is recommended to address each section of this form.

4. Do I have to provide enabling services for each of the areas list here?
Capturing the determinants of health are vital to understand what services each patient needs. Do the best you can to assist each patient comprehensively.

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