Improve your coding speed and accuracy to improve reimbursements
Ever since 2004, fast and accurate ICD and HCC coding has been vital for health plans wishing to secure maximum reimbursements for Medicare Advantage patients. The coding process allows for health plans to receive reimbursement proportional to the health expenditure risk associated with each individual patient, which helps to ensure that all patients—even high-risk ones—receive adequate care and coverage.
Unfortunately, many health plan providers end up losing out on deserved reimbursements because of flaws in their HCC coding process. Here are 4 key improvements that should help maximize your company’s reimbursement rates.
Timely Annual Coding
HCC codes describing each patient’s medical conditions must be re-captured every 12 months. Missing a deadline can result in a funding gap of six months and significant hardship on the health plan provider. There are two ways in which the timeliness of this re-capturing activity can be improved. First, you can hire a company such as HCC Coders to provide prospective risk adjustment services. This involves working ahead on annual visit forms to pre-code all of the known conditions into the system, saving time later. Secondly, you can make sure you have a robust patient outreach program that will remind Medicare patients to schedule and attend their annual visits.
Detailed ICD 10 Training
Starting in October of this year, all health plans and medical offices will be required to switch from the old ICD 9 code set to the new ICD 10 set. Considering that ICD 10 has many, many more codes than ICD 9 and a completely different numbering protocol, this could slow your coding staff down significantly. You can avoid this potential issue by hiring pre-trained coders from HCC Coders who are already up to date on ICD 10.
Fast Medical Record Retrieval
Another factor that can influence your ability to secure deserved reimbursements is how efficient your medical record retrieval and transfer process is. The faster records can be transferred to your coders, the faster the work can be completed. HCC Coders provides helpful and secure software for this purpose.
Quality Control
Of course, the more accurate your code submissions are, the better your reimbursement rates will be. HCC Coders offers retrospective risk adjustment services to ensure all relevant codes have been captured, as well as an auditing feature in our software that allows you to spot-check the coders’ work for quality control purposes.