Medical Record Audit Services
Medicare reimbursement rates and bonuses are the driving factors for any Medicare Advantage Plan. Retrieving medical records for the right members, identifying missed diagnoses, and accurately capturing those additional HCCs in RAPS filings typically results in significant incremental revenue for a Medicare Advantage Plan.
Our HCC coding service helps extract all possible HCC codes to support Medicare Advantage plans in completing accurate risk assessment of their membership within the CMS deadlines. Our accuracy in coding allows our clients to maintain the balance between submitting what can be appropriately claimed and avoiding penalties for inaccurate data.
- Retrospective and Prospective Chart Reviews
- Coding to the highest specificity, based on the provider documentation, to maximize risk scores and reporting missed codes
- Certified/clinical coders (CPC & CCS) for in-depth focused chart review
- Validate documentation on all diagnosis codes in chart and codes hitting HCCs and highlight documentation errors
Our clients have not only received the benefit of cost while using our HCC review services, they have also seen an improvement in overall RAF scores.