Metacare has developed patent-pending AI coding technology in-house complemented with expert human coders to identify and code HCCs to the highest specificity, optimizing risk adjustment scores and maximizing reimbursements compliantly.
Hierarchical Condition Category (HCC) coding is critically important in value-based care. HCC coding directly impacts how much money you receive from payers. Patients with higher HCCs are expected to need more intensive medical treatment, so payers use HCCs to determine risk adjustment payments based on a patient’s complexity and risk for future disease and cost. Inaccurate coding can lead to substantial revenue loss.
When you are expected to deliver outstanding patient care in 20 minutes and immediately move onto the next patient, it becomes easy to forget a couple HCC codes, resulting in a negative impact on reimbursement and quality of care.
Hierarchical Condition Category (HCC) coding is a critical component of medical coding that offers numerous benefits for practices. It primarily focuses on accurately reflecting the health status and risk profiles of patients, which in turn impacts reimbursement rates and overall care quality. Here are the key benefits of HCC coding for practices:
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