Accurate risk adjustment isn’t just a box to check; it’s now a strategic lever. Hierarchical Condition Category (HCC) coding underpins risk scores that drive Medicare Advantage and other value-based ...

Every once in a while in life, one goes through a big move. It can be because of moving houses, or changing jobs, or...because every diagnosis code that has ever been entered in a patient's chart has ...

Claims data, which form the foundation of risk adjustment in payment for health care services, may reflect efforts to capture more—or more severe—clinical conditions rather than true changes in health ...

Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...

The following is a guest post from Rodrigo Martinez, MD, Senior Vice President, Consulting at Advisory Board Company. As the shift toward value-based care and risk-based contracting progresses, it ...

Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with Penguin Ai's HCC Coding & Risk Adjustment Snowflake Native App PALO ALTO, Calif., Jan.

A new rule proposed by the Centers for Medicare and Medicaid Services (CMS) on October 26, 2018, would revise the way the agency validates the risk adjustment data and collects repayments from ...

Although there are main clusters of ICD-9 HCC codes, there are more than 3000 HCC codes overall. The CMS General Equivalence Mappings of codes may reflect over 11,000 HCC codes in ICD-10. As a current ...