Risk Adjustment Coding in Portland OR

HCC Coders can assist with risk adjustment coding in Portland OR

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. Naturally, health plan providers need accurate risk adjustment coding in Portland OR in order to comply with CMS requirements and secure appropriate reimbursements from Medicare Advantage. 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 Portland OR

HCC codes must be re-reported every twelve months or health plan providers risk losing out on their reimbursements. Prospective risk adjustment coding in Portland OR 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 Portland OR

Audits and retrospective risk adjustment coding in Portland OR 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

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