Risk Adjustment And HCC Coding Best Practices [Infographic]

by | Jan 13, 2022 | Resources, Infographics | 0 comments

Hierarchical Condition Category or HCC coding helps paint a picture of the whole patient and communicate patient complexity. Correct HCC coding enables better health management and helps proper assessment of quality and cost performance for accurate reimbursements from Medicare Advantage plans. Not adhering to risk adjustment and HCC coding requirements can adversely impact practice/hospital revenue. Risk adjustment is a method to offset the cost of providing health insurance for individuals with chronic health conditions. In a risk adjustment model, the payment rate for each patient depends on a variety of factors that determine the amount of risk/work involved to provide care for the patient. There are various risk adjustment models. HCC relies on ICD-10 coding to identify a patient’s health conditions and assign a risk score. The CMS uses HCC method to calculate risk scores. Partnering with an expert medical coding service provider can ensure appropriate reimbursement and reduce risk of denials and audits.

Check out the infographic below

Risk Adjustment and HCC Coding

Related Posts

Contact Us

OSI Featured Experts

  • Natalie Tornese
    Natalie Tornese
    CPC: Director of Revenue Cycle Management

    Natalie joined MOS’ Revenue Cycle Management Division in October 2011. She brings twenty five years of hands on management experience to the company.

  • Meghann Drella
    Meghann Drella
    CPC: Senior Solutions Manager: Practice and RCM

    Meghann joined MOS’ Revenue Cycle Management Division in February of 2013. She is CPC certified with the American Academy of Professional Coders (AAPC).

  • Amber Darst
    Amber Darst
    Solutions Manager: Practice and RCM

    Hired for her dental expertise, Amber brings a wealth of knowledge and understanding of the dental revenue cycle management (RCM) services to MOS.

  • Loralee Kapp
    Loralee Kapp
    Solutions Manager: Practice and RCM

    Loralee joined MOS’ Revenue Cycle Management Division in October 2021. She has over five years of experience in medical coding and Health Information Management practices.