Understanding HCC Coding Through the Payer’s Lens: Why Precision Directly Impacts Revenue
In risk-adjusted payment models, every detail matters. Each diagnosis a provider documents adds to the overall financial picture. Missing even a single HCC code doesn’t
Best Practices for Payers to Improve HCC Accuracy
The U.S. Department of Health and Human Services notes that about 1 in 10 payments to Medicare Advantage groups are inaccurate, usually because some diagnoses
Unlocking Revenue Potential: How Accurate Risk Adjustment Drives Financial Performance
Risk adjustment and revenue cycle management (RCM) appear to be separate functions, with one focusing on clinical accuracy and the other on financial workflow; however,
Five Practical Tips to Strengthen HCC Coding Accuracy and Risk Adjustment
Accurate Hierarchical Condition Category (HCC) coding remains a major challenge for healthcare organizations. In Fiscal Year 2024, Medicare Advantage recorded a 5.61% improper payment rate,
Achieving Precision in HCC Coding and Risk Adjustment
In healthcare, knowing how complex a patient’s needs are isn’t optional; you miss that, and the consequences can be costly, both financially and clinically. Risk
