Risk Adjustment Coding in Durham NC

HCC Coders can assist with risk adjustment coding in Durham NC

Risk adjustment coding is a vital part of the CMS Risk Adjustment Model, which utilizes thousands of ICD 10 diagnosis codes and 80 HCC codes to track and predict patient care needs and expenses. Obviously, as a health plan provider you want to know that your risk adjustment coding in Durham NC is being done correctly so you can secure the maximum reimbursements from Medicare Advantage. By providing the staff needed to complete risk adjustment coding, HCC Coders helps health plan providers comply with their coding obligations.

We Provide Prospective Risk Adjustment Coding in Durham NC

HCC codes must be re-reported every twelve months or health plan providers risk losing out on their reimbursements. Fortunately, such a scenario can be avoided with prospective risk adjustment coding in Durham NC from HCC Coders. Prospective coding activities include pre-coding annual visit forms for existing plan enrollees. By working ahead in this way, health plan providers can avoid feeling so much pressure around annual coding deadlines. Prospective coding also helps improve accuracy by identifying missing codes early.

We Perform Retrospective Risk Adjustment Coding in Durham NC

Retrospective risk adjustment coding in Durham NC is also very important because it helps ensure coding accuracy and maximize reimbursements. The following activities are included in our retrospective risk adjustment services:

  • 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

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