Accurate risk adjustment isn’t just a box to check; it’s now a strategic lever. Hierarchical Condition Category (HCC) coding underpins risk scores that drive Medicare Advantage and other value-based ...
The following is a guest post from Rodrigo Martinez, MD, Senior Vice President, Consulting at Advisory Board Company. As the shift toward value-based care and risk-based contracting progresses, it ...
To facilitate full and accurate Hierarchical Condition Category (HCC) coding, it is crucial that providers take a disciplined approach to documenting medical encounters in patient records. The AAPC ...
Claims data, which form the foundation of risk adjustment in payment for health care services, may reflect efforts to capture more—or more severe—clinical conditions rather than true changes in health ...
Inaccurate HCC coding can lead to significant financial implications and variability in Risk Adjustment Factor scores. A new infographic released by PYA illustrates why coding accuracy is paramount ...
In two Forefront articles on September 29 and September 30, 2021, “Medicare Advantage, Direct Contracting, And the Medicare ‘Money Machine’,” Drs. Don Berwick and Rick Gilfillan argue that Medicare ...
The medical coding landscape is evolving rapidly due to increased regulatory complexities, the adoption of ICD-11, and AI-driven automation. Healthcare providers demand coders who are not only ...
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