HCC Coders can assist with risk adjustment coding in Sacramento CA
The CMS Risk Adjustment Model utilizes thousands of ICD 10 codes to support patient categorization into dozens of HCC codes, all in the name of predicting health care expenditures and determining insurance reimbursements. It is very important for health plan providers to ensure that they are conducting accurate and timely risk adjustment coding in Sacramento CA 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 Sacramento CA
HCC codes must be re-reported every twelve months or health plan providers risk losing out on their reimbursements. Prospective risk adjustment coding in Sacramento CA can help prevent revenue gaps due to missed re-reporting deadlines. 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 Sacramento CA
Audits and retrospective risk adjustment coding in Sacramento CA help ensure that coding has been done correctly so that health plan providers can receive the maximum possible reimbursements. As part of our retrospective risk adjustment coding services, we will complete the following:
- 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