How HCC Coding Companies Help Your RAF Scores Tell the Real Story
Ever stare at your RAF scores and think, โThese canโt be right?โ You know your members are complex. You see the chronic conditions and comorbidities. Yet on paper, the numbers…
5 Ways Payers Can Ensure Risk Adjustment Compliance
As Medicare Advantage (MA) plan options have expanded, the number of insurers wading into MAโs often murky waters is likewise growing. This shift to value-based care from fee-for-service care that…
Risk Adjustment and the Renewed Importance of HCC Coding
The financial health of many risk-bearing providers hinges on compliance with risk adjustment and hierarchical condition category (HCC) coding directives associated with Medicare Advantage plans and certain Medicaid plans. Yet…
Accurate RAF Scores Could Mean Billions in Savings for Medicare
A recent study published by the Kaiser Family Foundation sheds light on a complex issue โ how to determine the real or predicted cost of care for Medicare Advantage plan…