With CMS tightening risk adjustment payments to plans and conducting RADV audits, Medicare Advantage Plans must adopt a proactive strategy to prepare for audits while ensuring accurate reimbursement from CMS.
For 2011, CMS expanded the Hierarchical Condition Categories (HCC) from 70 groups to 87, increasing opportunities for correct diagnosis code classification and more accurate risk adjustment.
At Codicent, our Retrospective Chart Review service includes all processes necessary to implement a successful review that can result in higher plan reimbursements.
By combining meticulous record retrieval with accurate coding, we help Medicare Advantage Plans maximize reimbursement while maintaining CMS compliance.
By listening, we understand our clients’ unique needs and select only the most qualified candidates for your organization.