HCC Coders can assist with risk adjustment coding in Irvine CA
The CMS Risk Adjustment Model was established to help predict heath care costs. In this model, thousands of ICD 10 diagnosis codes are used to classify patients into the appropriate HCC code categories, which are in turn used to determine reimbursements. Obviously, as a health plan provider you want to know that your risk adjustment coding in Irvine CA is being done correctly so you can secure the maximum reimbursements from Medicare Advantage. HCC Coders can help health plan providers by providing the staff needed to complete coding activities.
We Provide Prospective Risk Adjustment Coding in Irvine CA
Without timely annual re-reporting of HCC coders, health plan providers will not receive their maximum reimbursements on time. Prospective risk adjustment coding in Irvine CA can help prevent revenue gaps due to missed re-reporting deadlines. By conducting prospective coding activities, health plan providers can work ahead on annual visit forms, filling in known codes on existing patients without deadlines looming. Prospective risk adjustment coding makes it less likely that codes will be overlooked.
We Perform Retrospective Risk Adjustment Coding in Irvine CA
Audits and retrospective risk adjustment coding in Irvine CA help ensure that coding has been done correctly so that health plan providers can receive the maximum possible reimbursements. Benefits of our retrospective risk adjustment services include:
- Validation of diagnosis codes with medical records
- Highlighting of any key coding or documentation errors or omissions
- Inclusion of Part C and Part D coding in HCC data capture
- Identifying opportunities for coding improvement and education using summary reports of physician chart audits