HCC Coding
Ensure Accurate Reimbursement
Medical groups and health systems need to control leakage, cost and quality. Our referral management solution is a tech-enabled way to achieve those goals by creating an organizationally approved algorithm that honors physician preference, patient preference and system alignment.
Prospective HCC Coding
• Days before the encounter, our certified coders conduct a two-year review of the patient chart data.
• All needed data is pushed to the scheduled appointment for the provider to review—allowing the provider to validate and capture accordingly.
• 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
Quality Standards
Our certified HCC coders deliver an average coding accuracy of 95% to lead providers with quality efficiency and operational ROI. We’ll apply a quality assurance process within the system to ensure accuracy benchmark is achieved and provide regular reporting for process assurance.
Iris Medical Agent AI Platform Integration Available
If your health system uses our Iris Medical Agent AI Platform, 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 to improve productivity. For more information speak to one of our sales agent, or contact us today to learn more.