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

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

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

hcc coding technology inferscience

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.

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

How to Improve Medicare Risk Adjustment Scores

Posted by Lucy Medina on Sep 1, 2020 12:01:59 AM

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. 

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Topics: Medicare, hcc coding tools, hcc coding technology

Impact of Coronavirus for Healthcare Providers:  Billing & Coding Operations

Posted by Lucy Medina on Apr 3, 2020 4:38:36 PM

Doctors using computer looking at files in medical office-1

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. 

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Topics: Medicare, hcc coding tools, hcc coding technology

Updates on Medicare's Telehealth Coverage During the Coronavirus Crisis

Posted by Lucy Medina on Apr 1, 2020 1:49:37 PM

Doctor working at the hospital on a laptop and holding x-ray

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.

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Topics: hcc coding tools, hcc coding technology

HCC Coding Technology in the New Year

Posted by Lucy Medina on Jan 27, 2020 10:03:15 AM

hcc computer image

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

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

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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.