The shift from fee-for-service to fee-for-value has changed the way physicians provide care, bill for services, and get reimbursed. As three out of four Americans are living with multiple chronic conditions, proper chronic care management is critical to improve...
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...
In a world of value-based care, the need for quality reporting by physicians is growing in importance. Accurate documentation and HCC coding (Hierarchical Condition Categories coding) is necessary to report medical care for high-risk, high-complexity conditions. Since...