Fall is finally here! That means a few things; cooling temperatures, the return of football, and that school is back in session. Are you secretly jealous of your children and their crock of new school supplies and fresh new text books? If so, take a step back from the new History textbook and take a deep breath. You too can get that back to school feeling. How you ask? With the help of our team at HCC Coders. Sit back, relax, and take a refresher course on HCC Coding!
What is HCC Coding?
HCC Coding is Hierarchical Condition Category Coding. This was implemented by Medicare in 2004 as a way to adjust capitation payments for private healthcare plans. HCC codes are primarily based on health expenditure risk profiles that are derived for Medicare Advantage Plan members. The CMS Risk Adjustment Model also uses HCC’s to measure the disease burden.
Why does HCC Coding matter?
HCC coding is important for a variety of reasons. Under the CMS model, HCC risk scores play into benchmark calculations for MSSP ACO’s and also the capitation rates for Medicare Advantage plans. These scores are also relevant when considering exchange-based insurance products because CMS now uses a modified version to calculate risk scores for people that are looking to purchase plans from the federal health insurance exchange. Because of this, it is important to have accurate and updated HCC’s.
What are the challenges with HCC Coding?
Aside from the overall confusion that ensues when trying to decipher HCC codes, there are other challenges associate with it. One is that MA plans use different methodologies to capture HCC codes from their providers. That means relying on the documented data offered up by the provider and this is not always accurate. This information often fails to contain accurate and thorough information, hence the difficulty. Without accurate and thorough information, there are gaps in the coding.
Do you need help with your HCC Coding tasks? If so, the experts at HCC Coders can assist.
Even with a refresher course, it’s easy for your head to be spinning when it comes to HCC coding. That’s because nothing is simple in the medical industry, especially in this country. Thankfully, there are avenues that you can venture down to seek relief.
If you need help with your HCC coding, turn to HCC Coders! Since 0 we have been working to become one of the most reliable, accurate, and affordable options for health plan representatives looking for assistance with the HCC coding tasks. As a division of Datafied, you can rest assured that our coders are highly skilled and professional. Plus, with our HCC Navigator software, they can work entirely remotely, delivering you the assistance you need without taking up any workspace at your facility.
To learn more about HCC Coders or get connected with one of our qualified coders, contact us today at 877-328-2343.