A recent article in Neurology Today highlights the importance of accurate Medicare Risk Adjustment / Hierarchical Condition Categories (HCC) coding for physicians practices and RADV audit services for insurance companies offering Medicare Advantage (MA) plans....
Changing regulations and reimbursement methodologies such as risk-adjusted and value-based models has put the focus on risk adjustment and hierarchical condition coding or HCC coding. Risk adjustment factors are used by government and many private payers to adjust...
Costly chronic conditions of ICD-10-CM have been classified by CMS into Hierarchical Conditional Categories (HCCs). Patients with HCC conditions require more resources and disease intervention. The Risk Adjustment process identifies patients who are more costly to...
Submitting claims with the right procedure and diagnosis codes is crucial for getting paid correctly. When it comes to Medicare Advantage (MA), payment depends on reporting care for patients with serious, complex conditions. The Centers for Medicare & Medicaid...
The Centers for Medicate and Medicaid (CMS) developed the Hierarchical Condition Categories (HCC) to calculate risk scores and adjust capitation payments made for beneficiaries enrolled in Medicare Advantage (MA) plans. The CMS Risk Adjustment Model includes nearly 80...
