Tag Archives: HCC

Midwest health plan recovered over $5K per ACA member after a pilot of MedKoder’s Risk Adjustment Management Technology Health plans and health systems are financially dependent upon the specific documentation of each individual patient’s diagnoses as classified within the highly specific CMS Hierarchical Condition Category (HCC) system and the management of those conditions. Failure to […]

August 10, 2017 Risk Adjustment Validation (RADV) audits have two main purposes, to ensure contracts have met CMS’ submission requirements, and to validate HCC codes by ensuring the submitted diagnoses are supported by medical documentation. If selected by CMS for a RADV audit, a mistake in either one of these areas can have severe financial […]

June 8, 2017 Chart reviews can be useful in uncovering common documentation errors that impact both Medicare Advantage payments and potentially patient care. However, many healthcare organizations across the country are getting penalized by the Centers for Medicare and Medicaid Services (CMS) based on the medical record data they are submitting, due to inaccurate/missing HCCs or risk adjustment […]

What a great turn out! Thanks to everyone who attended MedKoder’s live webinar: Just when you think you captured all of your HCC opportunities…Think again!  Thu, April 27, 20171:00 PM – 2:00 PM CDT If you didn’t make the webinar and want to learn more about HCC Capture Best Practices and ROI on risk/value based […]