100+
Satisfied Clients
30%
Practice Revenue Rise
99%
Collection Rate
Comprehensive MRA Coding Services
Having problems capturing the diagnoses of your Medicare Advantage patient population? Our Medicare Risk Adjustment (MRA) coding services provide the solution!
Healthcare providers need to receive fair compensation for treating patients with varying levels of health risks, especially those with chronic or severe conditions.
Medicare Risk Adjustment (MRA) coding plays a vital role in ensuring you are appropriately reimbursed based on the health status and risk profiles of your Medicare Advantage patients. Our comprehensive MRA coding services help optimize your revenue by ensuring accurate and compliant documentation of patient diagnoses.
Accurate Diagnosis Coding for Enhanced Risk Adjustment
Accurate MRA coding is crucial for capturing the full picture of a patient’s health status, ensuring that Medicare Advantage plans reflect the appropriate level of risk. This not only ensures you receive proper payment for the care you provide but also minimizes the risk of audits, payment delays, or penalties due to incorrect coding or incomplete documentation.
The HCC model uses ICD-10 codes to categorize patient diagnoses into different hierarchical condition categories. As experts in Hierarchical Condition Category (HCC) coding, we can ensure that all diagnoses are captured accurately and comprehensively.
Our MRA Coding Services: Comprehensive Compliance and Audit Support
Our MRA coding services ensure that submitted diagnosis codes meet risk adjustment submission requirements (set by the MA plan).
Our support includes:
Expert coding support
Our certified coders specialize in MRA and HEDIS coding, ensuring accurate documentation of chronic diseases and HCC codes in alignment with CMS requirements and quality reporting standards.
Thorough chart reviews
We conduct detailed chart reviews to capture all diagnoses accurately, preventing missed risk adjustment opportunities and underpayment.
Compliance with CMS guidelines
Our services ensure adherence to CMS regulations, staying updated with changes to minimize coding errors and penalties.
Verify patient information
We verify patient details, including demographics and medical history, to ensure assigned codes accurately represent the patient’s current health status.
Internal audits
We conduct claim audits to ensure all correctly documented diagnosis codes have been submitted, including both retrospective and prospective audits.
Monitor coding trends and patterns
Our team tracks trends to identify potential issues early and implement improvements before they escalate into larger problems.
By ensuring the accurate capture of HCC codes and relevant patient diagnoses, we help you maximize your reimbursement potential. Our skilled team makes sure that all conditions are properly reflected in the risk adjustment process, so your practice gets paid for the level of care provided.
Benefits of Our MRA Coding Services
High Accuracy
Our coders have deep expertise in MRA and HCC coding, ensuring that all diagnoses are captured thoroughly and accurately.
Optimized Revenue
By capturing the complete health status of patients, we help you receive the appropriate compensation for complex cases.
Reduced Risk
We help reduce the risk of audits and denials by ensuring compliance with the latest CMS guidelines.
Streamlined Processes
By easing the burden of risk adjustment coding, we help physicians focus on patient care.
We serve all 50 states
Why Choose Us?
- Experienced certified coders
- Customized solutions
- Compliance driven approach
- Proven track record
- Stringent QA
- 30 to 40% cost savings
Flexible Pricing Options
Choose from our transparent and cost-effective pricing models:
Full-Time Equivalent
In this model, services are billed based on the equivalent cost of a full-time employee (FTE) for a specified duration, usually monthly or annually.
Per Verification Billing
Like an FTE model, a person is dedicated to your practice. Perfect for a practice that is busy. They work as an extension to your business.
FTE/Per Verification Billing
This option is ideal for a practice that is unsure about their work requirements. This can have per request pricing for eligibility and other functions.
FAQs
How does accurate MRA/HCC coding impact healthcare organizations financially?
Accurate coding directly influences the reimbursement received by healthcare organizations caring for Medicare Advantage patients. Proper coding ensures that providers are adequately compensated based on the health risk of their patient population, contributing to financial stability and enabling the delivery of high-quality care.
What sets your services apart from others?
Our MRA/HCC coding services are distinguished by a meticulous approach to data collection, certified coders with expertise in Medicare coding guidelines, and a commitment to continuous education and improvement. We prioritize accuracy, compliance, and collaboration with healthcare providers to optimize the risk adjustment process.
How do you ensure compliance with CMS guidelines?
Our coding processes adhere rigorously to CMS guidelines, with regular updates to reflect any changes in coding requirements. Internal validation and auditing processes are in place to ensure strict compliance, and our team undergoes continuous training to stay current with CMS regulations.
How frequently should MRA coding be updated for accurate risk adjustment?
MRA/HCC coding should be an ongoing and dynamic process, continually reflecting changes in patient health status. Regular updates, ideally concurrent with patient visits, help maintain accuracy in risk assessment and reimbursement, contributing to a more precise representation of the patient population’s health risk.
How do you collaborate with healthcare providers to improve coding accuracy?
We establish a collaborative feedback loop with healthcare providers, offering education on accurate documentation and coding practices. Regular communication, training sessions, and data-sharing foster a partnership aimed at enhancing coding accuracy and overall risk adjustment effectiveness.
Related Posts
Why Physicians Need to Pay Special Attention to MRA Coding
by Natalie Tornese | Posted: Apr 29, 2016
5 Strategies to Succeed with Risk Adjustment
by Julie Clements | Posted: Apr 12, 2023
Risk Adjustment and HCC Coding – A Look at Best Practices
by Meghann Drella | Posted: Feb 23, 2021