Risk Adjustment Coding in Santa Monica CA


HCC Coders can assist with risk adjustment coding in Santa Monica 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. Obviously, as a health plan provider you want to know that your risk adjustment coding in Santa Monica CA is being done correctly so you can secure the maximum reimbursements from Medicare Advantage. Health plan providers can turn to HCC Coders for support in carrying out vital coding activities.

We Provide Prospective Risk Adjustment Coding in Santa Monica CA

If HCC codes for all patients are not re-reported annually, health plan providers risk 6-month revenue gaps in their reimbursements. At HCC Coders, we help make sure you meet your coding deadlines by providing prospective risk adjustment coding in Santa Monica CA. 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 Santa Monica CA

Audits and retrospective risk adjustment coding in Santa Monica CA help ensure that coding has been done correctly so that health plan providers can receive the maximum possible 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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