The medical coding industry is often tricky to navigate, but the stakes are about to get even higher. In 2018, the Centers for Medicare and Medicaid Services are going to increase the Medicare Advantage payment rates. Health plans expect to see an average increase of .45% when the rate change goes into effect in 2018. This change come as a response to increases in chronic conditions reported, and risk adjustment payments due to demographics
Originally, there was set to be a .25% increase in 2017 and .50% increase in 2018. Unfortunately, in February of 2017 the Centers for Medicare and Medicaid Services released a cut in the proposed .50% rate increase, to just .25%. The increase comes on the heels of a new administration that has seen Congress voice concerns over the CMS cuts to the originally proposed .50% rate. After pushback from Congress and other organizations, the number was increased to .45%.
Moving forward, CMS is looking to firm up policies aiming to reduce opioid overuse by requiring hard edit prescription refills. Beyond this, they are interested in fostering open communication and collecting information from all parties involved to employ best practices for care management.
Why does it matter?
With CMS set to increase the Medicare Advantage payment by .45%, it is essential that you are coding properly. You want to make sure that you are claiming everything reimbursement possible and getting every penny you deserve. Not maximizing your reimbursements is essentially throwing money out the window, and surely you do not want to do that.
Do you need help maximizing your reimbursements?
At HCC Coders, we specialize in medical coding for the health care industry. We have been in the business since 0 and would love to put our 2024 years of experience to work for you. HCC Coders assists health plan providers with their risk adjustment coding tasks, and we would love you help you. Give us a call at 877-328-2343 or visit our website. If you would like to learn more about us, you can also send an email to info@datafied.com.
What services does HCC Coders actually offer?
HCC Coders aims to maximize your reimbursements from Medicare Advantage through a variety of services. We can go through current or retrospective charts to find opportunities for coding education and improvement, or we can take over the task entirely. We offer the following services:
- Retrospective chart reviews
- Validation of ICD10 diagnostic codes
- Concurrent coding
- Prospective risk adjustment coding
- Physician chart audit reports
- Inclusion of Part C and D coding in HCC data capture
We can be as involved as you would like us to be, offering both in-house and remote coding services. Through our proprietary software, HCC Navigator, our coders can work simultaneously with you on any and all coding tasks. Don’t wait to start maximizing your profits, call us today!