Capture Clinical Complexity. Strengthen Risk Accuracy.
Risk adjustment coding requires accurate identification and documentation of clinically supported conditions that influence patient risk profiles and reimbursement models. Our HCC coding services help healthcare organizations review medical records and identify supported hierarchical condition categories and other risk-relevant diagnoses.
Our specialists evaluate documentation across qualifying encounters to ensure that reported conditions are appropriately supported and coded according to applicable guidelines.
Comprehensive assignment of CMS-HCC and HHS-HCC diagnostic categories based strictly on documented clinical evidence and MEAT criteria.
Learn moreIn-depth examination of outpatient and inpatient clinical encounters to substantiate condition severity and diagnostic specificity.
Learn moreSystematic identification of persistent chronic conditions and co-morbidities requiring ongoing evaluation, management, and annual recapture.
Learn moreVerification that reported diagnoses meet official coding guidelines, provider documentation standards, and regulatory substantiation.
Learn moreAccurate cross-walking from provider clinical narrative and EHR discrete data to specific ICD-10-CM codes and corresponding HCC categories.
Learn moreMultidisciplinary chart evaluations ensuring that every qualifying encounter accurately reflects patient clinical acuity and risk status.
Learn moreAlgorithmic and clinical detection of suspect conditions based on lab values, medications, and historical trends for provider consideration.
Learn moreRigorous dual-tier quality reviews and RADV audit preparedness assessments to ensure complete defensibility and compliance.
Learn moreFlexible review methodologies supporting both concurrent pre-encounter planning and retrospective post-encounter validation.
Learn moreActionable analytics on RAF score distribution, recapture rates, suspect condition resolution, and documentation improvement opportunities.
Learn moreAccurate identification of supported conditions helps create a more complete representation of patient complexity.
Our review process connects documented clinical conditions with appropriate coding.
Systematic chart review helps identify supported diagnoses that may otherwise be overlooked.
Coding decisions remain grounded in documented clinical evidence and applicable coding requirements.
Contact us today to discuss how our certified HCC coding and chart review specialists can support your risk-bearing contracts and documentation integrity.
