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...
The Centers for Medicare and Medicare (CMS) has released new health insurance market place rules which will take effect from January 17, 2017. Referred to as the “payment notice,” the rule is an annual CMS omnibus rule that covers all the major changes that CMS plans...
Utilizing Natural Language Processing (NLP) based technology and big data analytics, the University of Pittsburgh Medical Center (UPMC) health plan has successfully processed millions of clinical documents to accurately identify risk adjustment or HCC coding...
The Medicare risk adjusted payment model is one of the major changes that have impacted physician practice revenue since it was introduced. The Centers for Medicare & Medicaid Services (CMS) uses the HCC (Hierarchical Condition Category) risk stratification...
HCC coding is important for health practices to increase their reimbursement opportunities. Outsourcing to a professional medical billing and coding company could ensure that the coding is accurate and claims are submitted in a timely manner. Making the Most of the...
