Comprehensive HCC Coding and Risk Adjustment Solutions
Codicent helps streamline Hierarchical Condition Categories (HCC) processes between IPAs/Medical Groups and Health Plans through comprehensive analysis aimed at improving physician HCC coding—a critical component of the CMS Risk Adjustment Model. Our solutions address the root causes of missing or incorrect HCC coding, ensuring accuracy and compliance.
We provide provider training with a guaranteed >95% code accuracy rate, physician-led audits of auditors, and trained clinicians who optimize member evaluations in line with Medicare Advantage guidelines.
Codicent provides comprehensive HCC code extraction to help Medicare Advantage plans perform accurate risk assessments of their members. We ensure complete and precise data submission in compliance with CMS requirements and deadlines.
With CMS increasing oversight of risk adjustment payments and performing RADV audits, Medicare Advantage plans must take a proactive approach. Thorough audit preparation and accurate, complete documentation to support HCC coding are essential. This approach reduces compliance risks and helps ensure your plan receives the CMS payments it is entitled to.
While retrospective chart reviews help health plans capture all HCC-related diagnostic codes for members, they do not address the need for provider education and training. Codicent offers a unique solution by providing a staffed physician who can work directly with providers to improve documentation practices. A prospective approach allows health plans to identify, document, and pre-select claims before they are reported to CMS. This ensures more accurate submissions, enhances compliance, and supports optimal risk adjustment outcomes.
By listening, we understand our clients’ unique needs and select only the most qualified candidates for your organization.