Ensure Accurate Documentation

Ensure Accurate Documentation and Financial Predictability with Medicare Risk Adjustment Coding Services

In health insurance, risk adjustment is like a tool that helps account for everyone’s health and expected medical costs in a plan. It’s crucial for doctors to accurately document diagnoses to make this tool work well. CMS’ Medicare Advantage program heavily depends on risk adjustment to make sure it can predict and budget payments properly. This helps provide benefits to all those enrolled in the program. Reliable Medicare risk adjustment coding services are crucial to keep offering good benefits and continue improving healthcare.

Outsource Strategies International (OSI) provides error–free Medicare risk adjustment coding (MRA) services for healthcare providers. We provide complete medical record documentation and accurate diagnostic coding that will help you obtain timely reimbursement and ensure quality care for patients.

Choose our Medicare risk adjustment coding services for accurate documentation and improved benefits!

Why Consider Professional Risk Adjustment Coding Services?

Considering Medicare risk adjustment coding services is a strategic investment that ensures financial stability and regulatory compliance, and enhances the overall quality and efficiency of healthcare services provided to Medicare Advantage beneficiaries. Reliable services are essential for several compelling reasons:

  • Optimized reimbursements
  • Financial stability
  • Enrollee benefit enhancement
  • Compliance with regulations
  • Precision in documentation
  • Quality healthcare outcomes
  • Competitive advantage
  • Efficient resource allocation
Why Consider Professional Risk Adjustment Coding Services

Comprehensive MRA Coding Services

Payment model for Medical Risk Adjustment relies on CMS-HCC (Hierarchical Condition Category) codes that are derived from the ICD diagnostic codes. With sound knowledge in the latest coding trends and updates, our AAPC-certified medical coders report the correct HCC (Hierarchical Condition Categories) codes that CMS requires.

HCC codes are determined based on the five sources accepted by CMS, such as:

  • Principal
  • Secondary hospital inpatient
  • Hospital outpatient
  • Physician
  • Clinically trained non-physician
Accurate HCC coding services ensure precise risk assessment and helps to submit accurate and complete claims within the risk adjustment period. Our AAPC-certified medical coders, with their knowledge of various codes and the validation process and experience with insurance and governmental regulatory requirements, can provide complete medical record documentation and accurate diagnostic coding, resulting in timely reimbursement.

Our coders ensure accurate MRA coding and also identify any missing information in patient records that may not pass a CMS audit. Adhering to HIPAA guidelines, we ensure security and confidentiality for all your medical records and data.

Our MRA/HCC Coding Process

The MRA/HCC coding process involves several essential steps to accurately assess and document the risk profile of Medicare Advantage beneficiaries.

Our MRA/HCC Coding Process

Our MRA/HCC Coding Process

The MRA/HCC coding process involves several essential steps to accurately assess and document the risk profile of Medicare Advantage beneficiaries.

Our MRA/HCC Coding Process

Why Choose OSI?

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Enhanced productivity and increased revenue

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Scalable technology

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Inpatient / outpatient coding

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Reliable accounts manager for each client

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Customized services

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Fast and customized turnaround time

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Professional coding process

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Detailed audit trail

Affordable & Flexible Pricing Plans

Fixed Cost Pricing

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.

  • A dedicated employee or team member
  • Team handling multiple responsibilities
  • Preset pricing and production guidelines
  • No Start-up fees

Per Verification Pricing

Perfect for a practice that is unsure about their work requirements. This can have per request pricing for eligibility verifications and other functions.

  • Dedicated team or employee
  • Team handling multiple responsibilities
  • A per transaction or hybrid model
  • No Start-up fees
Drive financial assurance!
Partner with us for Medicare risk adjustment coding services!

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 in the coding process?

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 Medicare risk adjustment 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.