HCC Coders can assist with risk adjustment coding in Phoenix AZ
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. It is very important for health plan providers to ensure that they are conducting accurate and timely risk adjustment coding in Phoenix AZ so that they can meet CMS requirements and receive their reimbursements for care provided to Medicare Advantage enrollees. Health plan providers who want the best possible coding staff use HCC Coders to find their risk adjustment coders.
We Provide Prospective Risk Adjustment Coding in Phoenix AZ
If HCC codes for all patients are not re-reported annually, health plan providers risk 6-month revenue gaps in their reimbursements. Prospective risk adjustment coding in Phoenix AZ 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 Phoenix AZ
Audits and retrospective risk adjustment coding in Phoenix AZ help ensure that coding has been done correctly so that health plan providers can receive the maximum possible 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