Risk Adjustment Coding in Raleigh NC


HCC Coders can assist with risk adjustment coding in Raleigh 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. It is very important for health plan providers to ensure that they are conducting accurate and timely risk adjustment coding in Raleigh NC so that they can meet CMS requirements and receive their reimbursements for care provided to Medicare Advantage enrollees. HCC Coders can help health plan providers by providing the staff needed to complete coding activities.

We Provide Prospective Risk Adjustment Coding in Raleigh NC

Without timely annual re-reporting of HCC coders, health plan providers will not receive their maximum reimbursements on time. Prospective risk adjustment coding in Raleigh NC 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 Raleigh NC

HCC Coders also provides assistance with retrospective risk adjustment coding in Raleigh NC. This helps ensure coding accuracy and allows health plan providers to rest assured they are getting the right reimbursements. Benefits of our retrospective risk adjustment services include:

  • 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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