HCC Coding

OnPoint Healthcare Partners, Inc. Announces IRIS.ai

Ensure Accurate Reimbursement

Improved hierarchical condition category (HCC) coding is the key to accurate RAF scores. It helps your organization get reimbursed appropriately for the clinical care required for patient wellbeing. OnPoint offers thorough HCC coding services by certified coders—allowing you to capture revenue while improving provider experience.

Prospective HCC Coding

OnPoint streamlines deep clinical review for clinical decision support.

  1. Days before the encounter, our certified coders conduct a two-year review of the patient chart data.
  2. All needed data is pushed to the scheduled appointment for the provider to review—allowing the provider to validate and capture accordingly.
  3. Encounters are audited to ensure appropriate capture and recapture rates. If a code wasn’t captured, we query the provider to determine the reason.

Historical Reviews, Documentation, Notifications

  • Review of current year’s and previous year’s medical records
  • Identification and documentation of fully and partially substantiated ICD-10s that map to HCCs
  • Documentation to support re-capture of HCC codes
  • Provider queries with clinical context needed to streamline capture

Scope of Clinical Chart Review

Completed within the EMR, extensive review of prior clinical information includes:

  • Prior diagnosis coding information
  • Visit scheduling
  • PCP, specialty, IP discharge summary, labs, meds, imaging, procedures, and more

Quality Standards

Our certified HCC coders deliver an average coding accuracy of 95%. We’ll apply a quality assurance process within the system to ensure accuracy benchmark is achieved and provide regular reporting for process assurance.

IRIS™ Integration Available

If your health system also uses our IRIS Virtual Clinical Assistant™, we can integrate HCC coding services with that system. The use of IRIS™ is not required—our HCC coding services integrate with all major EMR systems.

For More Information

Learn more about our coding support services. Contact us, today.