Reducing Audit Risk with M.E.A.T. Criteria: Valuable Insights and Latest Technology

Posted by Lucy Medina on Aug 17, 2021 8:38:00 PM

meat criteria audit

How often do you monitor and audit the accuracy of your HCC Coding?

In past blog posts we've talked about the importance of HCC Coding & accurate risk adjustment documentation. In today’s blog, we will provide you with valuable information about how to take your HCC coding & risk adjustment to the next level with M.E.A.T. criteria auditing.

As a provider, you understand the importance of HCC Coding. You probably spend a good amount of time making sure you add the correct HCC codes to your documentation, and staying up to date with adequate supporting documentation for HCC codes - all this to decrease your risk of lower payments, audits, and financial penalties.

In order to document accurately, and make this process easier, healthcare organizations use M.E.A.T. criteria standards.  Following M.E.A.T. criteria standards ensures healthcare provider organizations, coding companies, practice management consultants and revenue cycle companies regularly monitor and audit for correct HCC coding. 

So what does M.E.A.T. stand for? Here's an easy way to remember:

Meat criteria for risk adjustment

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Topics: risk adjustment, HCC coding, hcc coding tools, hcc coding technology, medicare advantage, risk adjustment technology, meat criteria audit

How to use an HCC Coding Tool in your EHR; Featuring HCC Assistant

Posted by Lucy Medina on Jun 2, 2021 7:00:00 PM

Screen Shot 2021-04-15 at 3.09.28 PM

As we established in our previous blog post, technology is important for your healthcare organization in the new Covid-19 world. One of the primary reasons includes staying up to date with CMS’ extensive policies and regulations. 

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

Covid-19 on HCC Risk Adjustment Coding - A Year Later

Posted by Lucy Medina on Apr 29, 2021 9:30:00 PM

hcc risk adjustment coding

The pandemic presented many challenges over the past year, including stay-at-home orders that hindered access to healthcare. During the first half of 2020, many providers’ offices closed to all appointments except emergencies, which delayed routine and preventive care for millions of people. Statistics from the end of 2020 show that prospective risk scores used to pay Medicare Advantage (MA) health plans are trending lower than forecasted. According to a study by Avalere, “deferral of care during the COVID-19 pandemic is resulting in fewer claims and diagnoses among Medicare Advantage (MA) enrollees, which could lead to a 3%–7% reduction in 2021 risk scores and lower plan payments in 2021”. The increase in deferral of care might change drastically this year as the pandemic is subsiding and vaccine rollout continues.

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

Driving Provider Engagement in HCC Coding  and Risk Adjustment

Posted by Lucy Medina on Dec 16, 2019 11:22:20 AM

Concentrated medical team using laptop together in the office

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. 

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Topics: HCC coding, hcc coding tools

The Changing Role of the Provider in HCC Coding

Posted by Lucy Medina on Oct 3, 2019 11:46:08 AM

HCC Coding Tools

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Topics: HCC coding, hcc coding tools

How technology can help accurate HCC coding

Posted by Sunil Nihalani, MD & CEO on Dec 9, 2018 7:03:01 PM

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.

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Topics: HCC coding

Solving the challenge of real time HCC coding for providers

Posted by Sunil Nihalani, MD & CEO on Sep 23, 2017 6:22:20 AM

Down in the trenches of Medicare Advantage primary care, most providers in the business know the importance of HCC coding. However, for the busy practitioner who is taking care of the patient and dealing with an alphabet soup of mandates such as HEDIS, STAR, HCAHPS etc, it is quite a task to pay attention to HCC coding in real time. As a result, providers fall short and have to answer then queries from coders re HCC codes that may have been missed.

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Topics: Inferscience News, HCC coding, Improving Healthcare

Risk Adjustment Redefined

Posted by Sunil Nihalani, MD & CEO on Aug 23, 2017 11:06:35 PM

Inferscience is proud to announce the release of an innovative new technology for optimal HCC coding at the point of care in real time.  The HCC Assistant was designed to optimize accurate and real time documentation of the patient conditions critical to predicting the risk and future cost of Medicare Advantage patient populations.

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Topics: risk adjustment, Inferscience News, 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.