HCC Coding and risk adjustment documentation is a big part of your physician and coder teams daily tasks, but as Medicare Advantage enrollment continues to increase, it doesn’t seem to be getting easier. For that reason, a lot more healthcare providers are considering hiring a technology tool provider that can aid in the automation of HCC Coding and risk adjustment documentation.
Main Things to Consider When Looking for HCC Coding & Risk Adjustment Technology
Topics: hcc coding tools, hcc coding technology, medicare advantage, risk adjustment technology
As enrollment in Medicare Advantage plans grows, healthcare organizations need to be able to predict future healthcare financial resources and appropriate reimbursement. The Hierarchical Condition Category (HCC) risk adjustment model is used by CMS to estimate predicted costs for Medicare Advantage beneficiaries, and the results directly impact the reimbursement healthcare organizations receive.
Topics: Medicare, hcc coding tools, hcc coding technology
Impact of Coronavirus for Healthcare Providers: Billing & Coding Operations
The situation in the US with COVID-19 has continued to escalate day by day. Healthcare providers are at the front line of this challenging situation that is impacting the healthcare system in unprecedented ways. In these times of uncertainty, healthcare providers have many moving pieces to worry about, today we will focus on the documentation aspects of the novel coronavirus.
Topics: Medicare, hcc coding tools, hcc coding technology
Updates on Medicare's Telehealth Coverage During the Coronavirus Crisis
On March 6, congress passed the Coronavirus Preparedness and Response Supplemental Appropriations Act. This new rule allows healthcare providers to bill Medicare fee-for-service for patient care by Telehealth during the current coronavirus pandemic crisis.
Topics: hcc coding tools, hcc coding technology
CMS Proposed Interoperability Rule: Where is it at?
Topics: hcc coding technology
Topics: risk adjustment, hcc coding tools, hcc coding technology
Driving Provider Engagement in HCC Coding and Risk Adjustment
Despite the fact that revenue from risk-based contracts continues to increase for medical groups of all sizes, motivating providers to fully participate in their organization's risk adjustment efforts remains a challenge for healthcare organization leaders. Because of this, many organization leaders have started looking for different ways to motivate their teams of providers to drive better engagement in HCC Coding & risk adjustment documentation. In our first blog post of this series, we discussed the importance of HCC coding and optimal documentation, its challenges, and the role of the individual provider.
Topics: HCC coding, hcc coding tools
Topics: HCC coding, hcc coding tools
Healthcare data interoperability and open skies: At last some help from the government!
In February of this year, the ONC and CMS proposed a new interoperability rule that promises to be a game-changer for patients, providers, and software developers like us. Given that the federal government has spent tens of billions of dollars trying to get clinical providers on the electronic health record (EHR) bandwagon with, questionable results at best, it’s a case of better late than never. Here is my perspective as CEO of a clinical decision support startup that stands to benefit from the rule, once it is implemented.
Topics: Improving Healthcare, Start ups
How technology can help accurate HCC coding
Medicare Advantage plans use Risk Adjustment Factor (RAF) scores to determine patient care expenses. The RAF is therefore a benchmark that enables the Centers for Medicare & Medicaid Services (CMS) to estimate future spending. With higher RAF scores, the amount Medicare pays Medicare Advantage plans for patient care also increases. Ultimately the goal is to improve patient outcome with reduced costs. Risk adjustment can also affect physician income. More recently, Medicare is using the HCC model to allocate costs for patients in Medicare Accountable Care Organizations.
Topics: HCC coding
About Inferscience's Founder
With over 12 years of experience working with electronic health records (EHRs), Dr. Sunil Nihalani observed how EHRs are being under-utilized in clinical practices. Moreover, the HCC Coding & risk adjustment coding capabilities have been lacking in the clinician’s workflow. Dr. Nihalani’s vision is an HCC Coding tool solution that integrates with leading EHRs and HIT systems to analyze patient records and claims information to help physicians and coders capture and audit HCC codes within their workflows. With Inferscience’s HCC Assistant, Physicians can document HCC codes and plan of care information in real-time during the patient encounter. Now, one solution enables both payers and providers to succeed in today's value-based care market.
Learn more about Inferscience and HCC Coding Assistant by visiting our products page here.