What is HCC Coding and Why Is It Important?

What is HCC Coding and Why Is It Important?

If you are a health plan you need to have at least a basic understanding of what HCC coding is. However, the topic can actually be pretty complex and confusing, especially if you are new to the field. Thankfully, HCC Coders is here to help. With over 28 years of experience, we know the ins and outs of HCC coding, as well as why it is considered to be so important in the health industry. So, sit back, relax, and get ready for a quick HCC coding crash course.

What is HCC Coding?

HCC stands for hierarchical condition category coding. This is a risk-adjustment model that was originally designed to estimate future healthcare costs for patients. The model was created in 2004 by the Centers for Medicare & Medicaid Services (CMS) but is becoming even more prevalent as the healthcare industry shifts to value based payment models.

Hierarchical condition category uses ICD-10 coding to assign risk scores to individuals. Along with other demographic factors like gender and age, insurance companies use this coding scale to assign risk adjustment factor (RAF) scores to patients. Algorithms then predict healthcare costs for an individual based on their RAF score.

Why is HCC Coding important?

HCC coding is essential for health plans because it helps get an idea of the patient as a whole and their associated costs. HCC coding also helps predict health care resource utilization while adjusting quality and cost metrics.

Who can help with HCC Coding?

If you are struggling to keep up with your HCC coding in an accurate and timely manner, there is help available! At HCC Coders, we connect health plans with quality certified coders to assist with their HCC coding needs.

Contact HCC Coders today to learn more about the coding services that we offer to health plans!

When it comes to HCC coding, you want to make sure that you are submitting it in a timely and accurate manner. Failure to do so can lead to lost revenues, which impacts your bottom line directly. At HCC Coders, we help health plans with their HCC coding. From coding audits to full outsourcing of your coding needs, we can handle it all. Our skilled coders know the ins and outs of ICD-10 and ICD-10-CM codes as well as prospective risk adjustment coding, physician chart audit summary reports, and more. If you are interested in learning more about how our experienced and certified coders can assist you, give us a call today at 877-328-2343.

To learn more about the reliable and quality HCC Coding services that we offer, visit us on the web at HCC coding.