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Are you tired of sifting through mountains of coding reviews, only to find the same mistakes repeated over and over? As a health plan, it’s essential to ensure accurate hierarchical condition categories (HCC) risk adjustment coding reviews to protect your bottom line. But with so many
As the healthcare industry continues to evolve and become more complex, health plans are constantly seeking new ways to streamline their operations and improve patient outcomes. One area where automation has shown tremendous promise is in the realm of medical chart auditing – a critical
Are you preparing for the upcoming 2023 Mid-Year risk adjustment data submission? Are you worried about handling the increasing number of hierarchical condition category (HCC) medical coding tasks (e.g. chart review & audit) within tight deadlines? With the Centers for Medicare & Medicaid Services (CMS)
If you’re still struggling to get a handle on risk adjustment documentation and coding, don’t worry-you’re not alone. With constantly evolving regulations, changing reimbursement models, and increasing pressure to deliver high-quality care while managing costs, it’s no wonder so many Medicare organizations find themselves overwhelmed.
As a healthcare professional, you understand the importance of accurate coding and documentation, especially when it comes to Hierarchical Condition Category (HCC) coding. HCC coding is used to determine the risk adjustment factor for Medicare Advantage (MA) plans, which affects reimbursement rates for healthcare providers. Table
In healthcare, understanding the full scope of a patient’s health goes beyond reviewing test results or glancing at recent clinical notes. It requires a broader lens-one that captures the entirety of a patient’s health journey. This is where Metacare AI manifests its full potential. By
The ICD-10-CM Official Guidelines emphasize collaboration between healthcare providers and medical coders for accurate documentation. Medical records must include detailed clinical documentation from qualified physicians responsible for patient diagnoses. Understanding Today’s Healthcare Challenges Healthcare providers and health plans face mounting challenges with fragmented data across
The business of healthcare delivery requires a combination of learned, attentive patient care and thorough documentation for subsequent encounter reimbursement. Both goals can be enhanced with automated pre-visit chart reviews delivered through Pre-Encounter CDI-like NLP analytics, proving that the best way forward can often be
The business of healthcare delivery requires a combination of learned, attentive patient care and thorough documentation for subsequent encounter reimbursement. Both goals can be enhanced with automated pre-visit chart reviews delivered through Pre-Encounter CDI-like NLP analytics, proving that the best way forward can often be
With many healthcare organizations transitioning to value-based care (VBC) programs, ensuring accurate hierarchical condition category (HCC) documentation that leads to accurate risk adjustment factor (RAF) scores in risk adjustment is challenging. The objective of a risk adjustment program is to ensure accurate funding to health plans
In the release of the Medicare Advantage Risk Adjustment Data Validation Final Rule by the US Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), insurers are accountable for the diagnosis reported to claim Medicare reimbursements.¹ Insurers, also known as
Hierarchical condition category (HCC) coding is a risk-adjustment model which is designed to estimate future healthcare costs for patients as defined by the American Academy of Family Physicians (AAFP)1. This model was initiated by the Centers for Medicare & Medicaid Services (CMS) initiated in 2004
Are you tired of spending countless hours in order to ensure efficient coding for Centers for Medicare & Medical Services (CMS)/hierarchical condition category (HCC) reimbursements? Do you want to increase your efficiency and accuracy while coding? In this blog post, we will be sharing with you
Physicians are the unsung heroes of healthcare, dedicating their lives to saving others. However, the relentless administrative burden of clinical coding has significantly contributed to physician burnout. Enter Natural Language Processing (NLP), a cutting-edge technology revolutionizing healthcare by alleviating administrative stress, particularly in clinical coding.
The field of medical coding plays a vital role in healthcare, ensuring precise and standardized documentation of patient diagnoses, procedures, and treatments. With advancements in artificial intelligence (AI), the medical coding process has undergone a transformation, significantly improving efficiency, accuracy, and overall productivity. In this
Welcome to our latest blog post about a crucial element of healthcare billing: Hierarchical Condition Category (HCC) coding. If you’re not familiar with this term, don’t worry – we’ll be breaking it down in detail shortly. But first, let’s talk about why HCC coding matters so much
To remain solvent and profitable, healthcare payers must constantly seek new ways to optimize their operations, improve reimbursement accuracies, and avoid penalties. To achieve those goals, risk adjustment coding technology is becoming part of the standard toolset. With the increasing demand for accurate and efficient
