Hierarchical Condition Category (HCC) Coding

  • Risk Adjustment Retrospective and Prospective Chart Reviews for both MRA and CRA.
  • Correct coding to the highest specificity, based on the provider documentation, to maximize risk scores.
  • Certified, clinical coders (CPC, CCS, CRC) for in-depth, focused chart review.
  • Physician on staff to educate providers on documentation.
  • Validate documentation on all diagnosis codes in chart and codes hitting HCCs.
  • Key documentation errors highlighted.
  • Physician Chart Audit summary reports for HCC coding improvement opportunities and education.

5 Ways Healthcare Organizations Benefit from Remote Coding

Healthcare organizations require a high degree of accuracy in medical coding in order to keep their revenue cycle management systems running smoothly. From ensuring compliance with state and federal regulations, to making sure that reimbursements are paid on time and to the maximum, medical coding is the backbone of every healthcare organization’s financial health, whether it’s a small physician group or a large hospital.
Case Studies
Claims Management - Process Innovation and Technology Result in Cost Reductions
The Challenge: Prohibitive labor cost and considerably higher turnaround time due to large number of manual adjudications resulting from mismatched information between enrollment data and provider data.
Provider Data Management - Process Innovation and Technology Result in Cost Savings
The Challenge: A cost intensive update process required checking data on all provider information update forms, rather than the ones which were actually changed (typically only 40%).