Main Things to Consider When Looking for HCC Coding & Risk Adjustment Technology

Posted by Lucy Medina on Dec 10, 2020 3:23:52 PM
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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.

If you are one of the many healthcare organizations considering a technology provider, we lay out a few of the reasons why it is important as well as some of the top main points RISE has highlighted for this year. 

 

Why Say Yes to a Technology Provider

Having an HCC coding tool to help you review all documentation is going to automate the process and allow your team to have more documentation ready in time when it's time for major submission deadlines for Medicare Advantage (MA) and Affordable Care Act (ACA) risk adjustment programs..

Another important thing to consider - having risk adjustment technology in place can help your providers and coders identify HCC codes that need to be submitted in order to increase patient RAF scores. Increasing patient RAF scores will consequently maximize revenue coming from MA contracts. In times like these, healthcare organizations need to be able to receive the money deserved for their well provided services.

Improving patient care - having all diagnoses correctly documented will help avoid gaps in care and having a tool to automate documentation will help your providers do what they do best - care for their patient without having to spend extra time in documentation.

 

Main 3 Things to Look for in a Technology Provider (by RISE): 

  1. Product mix: Check that the vendor has a variety of products that can help solve the right needs for your risk adjustment team.
  2. Product maturity: Understand the vendor’s full capability with their solutions, how long they have been on the market and if they have reliable references.
  3. Product roadmap: It’s important to consider the technology vendor’s future plans. How can they support your organization in the future? Are there any future features that will be beneficial for your team?

 

Our Advice - Also look out for an organization that provides:

  1. Fast & easy implementation 
  2. Accurate information provided
  3. An experienced team that truly understands your coding & risk adjustment needs
  4. Reporting & analytics functionality
  5. Great customer service
  6. Good client reviews 
  7. Offer a prospective and concurrent approach

HCC Assistant by Inferscience

Inferscience’s HCC coding application helps providers optimize HCC coding and risk adjustment documentation. HCC Assistant is a cloud-based intelligent HCC coding and billing platform which is integrated with major EHRs. The platform utilizes advanced Natural Language Processing (NLP) to analyze unstructured data as well as utilizing standardized vocabularies to analyze structured data in the patient chart. The complex intelligent rules built into the HCC Assistant allow it to find diagnoses that may have been overlooked and represent opportunities to improve the documentation in real time. Where available, write back integration enables one click submission of HCC ICD-10 codes and supporting plan of care documentation back into the patient chart.

It is also important to mention that the HCC Assistant updates every year with any changes in CMS policies, so with the start of the year, it will suggest codes that include CMS changes in the 2020 rate announcement. 

To make sure all documentation is reviewed and validated, Inferscience offers an add-on product to work with the HCC Assistant, the HCC Validator. The HCC Validator uses advanced NLP technology to instantly validate HCC codes against MEAT criteria and issues a clear “Pass” or “Fail” grade. Because it’s SaaS-based, it works with leading EHRs or can be used as a standalone solution.

Having the aid of an HCC Coding tool such as the HCC Assistant and HCC Validator can facilitate HCC Coding and Risk adjustment documentation to generate results that will drive change for your practice. If you’re interested in adding HCC Coding technology for your practice, reach out to Inferscience at sales@inferscience.com or contact us at (617) 848 9502.

It is important to highlight the importance of using HCC coding technology to make documentation easier and help improve patient's RAF scores.

Inferscience’s HCC coding application helps providers optimize HCC coding and risk adjustment documentation. HCC Assistant is a cloud-based intelligent HCC coding and billing platform which is integrated with major EHRs. The platform utilizes advanced Natural Language Processing (NLP) to analyze unstructured data as well as utilizing standardized vocabularies to analyze structured data in the patient chart. The complex intelligent rules built into the HCC Assistant allow it to find diagnoses that may have been overlooked and represent opportunities to improve the documentation in real time. Where available, write back integration enables one click submission of HCC ICD-10 codes and supporting plan of care documentation back into the patient chart.

If you’re a healthcare provider looking for HCC Coding technology tools you can visit our website at www.inferscience.com or contact us at 617 848 9502. 

Topics: hcc coding tools, hcc coding technology, medicare advantage, risk adjustment technology

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About the Author

Lucy Medina is an experienced healthcare marketer with expertise in payer contracting and revenue cycle management. She joined Inferscience in the spring of 2019. Inferscience offers an HCC Coding tool 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.