Medical coding is nothing new. In fact, it’s been around for decades. What has changed, is the way coding is done and how the systems interplay. HCCs are important for the bottom line of health plans and it’s important to treat them as a priority instead of an obligatory hassle.
What is HCC Coding?
HHC, which stands for Hierarchical Condition Categories, is a risk adjustment model that has existed for quite some time. It recently increased in popularity when Medicare Advantage Plans began using RAF scores for reimbursements. It is important for every coder and commercial payer and it is important to stay up to date on HCC standards and updates.
What are HCCs Used For?
CMS uses HCCs to reimburse Medicare Advantage plans, but this is based on the health of the members of the plan. Payments are adjusted by demographic and patient health information. HCCs, these condition categories are used to predict resource use for Medicare Advantage patients. By classifying patients into the major HCC categories, such as asthma and pulmonary disease, diabetes, major depressive and bipolar disorders, specified heat arrhythmias, breast and prostate cancer, congestive heart failure, rheumatoid arthritis, and more, they CMS can accurately predict the costs that will need to be allotted for the annual care of every patient.
Why HCC Matters?
HCC is important for improving health management as well as obtaining accurate reimbursements for Medicare Advantage patients. With accurate HCC, you can improve the accuracy of your patient RA score, which ensures that you are getting the maximum reimbursement. Better HCC Coding also allows for more streamlined procedures because you will no longer need to constantly request patient records or audit claims.
What Does This Mean For You?
HCC coding is known as the great equalizer. It makes reimbursements more efficient, but you need to be up to date on what is really happening. It’s easy for coders to get comfortable and fall into habits, which can detract from the quality of their work. You know the importance of maintaining accurate coding and HCC Coders can help!
HCC Coders Can Help You Obtain the Maximum Medicare Reimbursement!
If you are looking to claim the maximum Medicare Reimbursements possible, your HCCs need to be in line. Unfortunately, that is not the case for all health plans. An inexperienced or overworked HCC Coder can be making mistakes that are costing you hundreds or thousands of dollars. HCC Coders can ensure that you are obtaining the reimbursements that you are entitled to. Our team of qualified coders know the ins and outs of the medical coding world and can handle a full outsourcing of your RA and HCC Coding, or simply review the recent work that your in-house coder has already completed. If you want to make sure that you are receiving the maximum reimbursements, call HCC Coders today at 877-328-2343!