HCC Risk Adjustment Coding Services

Hierarchical condition category (HCC) coding is at the core of the CMS’s risk-adjustment payment model. The intention is to help payers better project future cost of care for certain Medicare Advantage, Medicaid, and ACA members and to help providers accurately capture patient risk scores. An oversight of a substantiated diagnosis code means the individual will not be flagged for intervention. In turn, this means neither the payer nor the provider will be reimbursed at a rate appropriate for the care the individual needs.

Omega Healthcare can help. Our HCC risk-adjustment coding services result in more accurate documentation of patient demographics, health conditions, and health status. Risk adjustment coding brings important results: improved health outcomes, reduced costs, and proper reimbursement for payers and providers alike.

THE EXPERTISE YOU NEED

Our team of experts helps payers prepare and submit accurate and complete data in advance of CMS deadlines and helps educate providers on the benefits of quality documentation of high-risk patients. Services include:

• Retrospective reviews after treatment
• Concurrent reviews during hospitalization
• Prospective reviews for new encounters
• Risk verification
• RADV support
• Provider education

Results:

• 97% – 98% coding accuracy
• Quickly scale to meet your coding review needs—temporary or permanent
• Up to 60% savings on each medical chart review