Inferscience offers the best HCC Coding and Risk Adjustment services in Newton, MA. In this PDF, we will provide detailed information about how driving provider engagement in HCC coding and risk adjustment. If you provide the right tools and apply the recommended motivation tactics, it is important to maintain provider engagement by measuring results (data & more data!). You will need to provide weekly or monthly reports and feedback to your team to analyze not only what is improving but what needs improvement as well. Following an approach of analysis, planning and execution can help you achieve better goals for your team.
Start Optimal HCC Coding With HCC Assistant in Newton, MAInferscience
Inferscience offers the best HCC coding services in Newton, MA. Your team can analyze patients’ charts and capture HCC codes at the point of care. The HCC Medical Coding Assistant also provides a real-time risk adjustment factor (RAF) score to give you an idea of how the codes selected will impact the RAF score for a patient thereby predicting future funding and expenditures. The HCC Assistant Coder Workflow is a coder-focused version of the HCC Assistant, perfect for provider organizations that have coder assistance. It allows the coder team to pre-select HCC codes for the provider to approve at the point of care. For more information about our HCC coding services, please visit our website or contact us at 617 848 9502.
Using an HCC Coding Tool in your EHR: Instructions with HCC AssistantInferscience
Technology is crucial for your healthcare organization in the new Covid-19 era, as we stated in our earlier blog post. Keeping up with the complex policies and regulations of the CMS is one of the main reasons. For HCC coding to be successful, physicians must report all diagnoses that influence the patient's evaluation, care, and treatment, including coexisting diseases, chronic conditions, and treatments provided, according to an article in ICD Monitoring that was referenced by CMS. For many practices, it might be difficult to provide accurate documentation of all diagnoses on an annual basis; this is where an HCC coding tool can be useful.
Greater Interoperability in Healthcare 2022: Data & TechnologyInferscience
Inferscience offers the best HCC medicare risk adjustment services in Newton, MA. Inferscience has taken advantage of these new wider rules to expand functionality. Inferscience’s proprietary technology can extract clinical data from any web-based EHR and standardize it. The data can be made available to any application via API. It is the expectation that expanding functionality with these types of features will at the end of the day benefit providers and patients as well. The most important consideration, therefore, for the continuing success of this road map is for all interest groups to participate with attentiveness and intentionality. Because in the end, collaboration is the key to greater interoperability in healthcare.
Benefits of Reporting Tools for Risk Adjustment WorkflowsInferscience
Inferscience offers the best medicare risk adjustment coding technology in Newton, MA. The risk adjustment (RA) workflow process in healthcare is here to stay, and even if organizations are slowly catching up, there are a lot of gaps that need to be closed for it to become more efficient. There are several ways to help providers catch up and improve their workflows that will help their health outcome management and, by and large, improve their RAF scores.
Inferscience offers the best HCC Coding Technology in Newton, MA. This PPT post, the third of its series, will focus on an important topic for those providing services to Medicare Advantage patients: using technology to optimize the HCC documentation process and increasing RAF scores. We will talk about recent updates to the CMS-HCC program, as well as retrospective and prospective approaches toward risk adjustment analytics and coding. For more information about our HCC Coding Technology, please visit our website now or contact us at 617 848 9502.
Thoughts on Epic & Cerner's Embrace of 3rd-Party CollaborationInferscience
Inferscience offers the best HCC medical coding and Epic & Cerner EHR clinical support services in Newton, MA. When we launched our Infera Clinical Decision Support system seven months ago, we did so with Allscripts and athenahealth EHRs, because their initial set of APIs made it possible for Infera to harness the rich data from the patient charts to deliver patient-specific clinical recommendations.
What You Need To Know About Infera CDSS For Athenahealth's ClinicalsInferscience
Inferscience offers the best clinical decision support application services in Newton, MA. The Infera clinical decision support application from Inferscience is now available in the Athenahealth Marketplace. It reads structured and unstructured patient data from the EHR, then analyzes the unique details of the patient’s condition against its evidence-based clinical rules, delivering specific care recommendations in real-time. Infera is integrated with Athenaclinicals EHR and is certified by the Athenahealth More Disruption Please (MDP) program.
As a provider, you understand the importance of HCC medical coding. You probably spend a good amount of time making sure you add the correct HCC codes to your documentation and staying up to date with adequate supporting documentation for HCC codes all this to decrease your risk of lower payments, audits, and financial penalties.
Inferscience offers an add-on product to work with the HCC Assistant, the HCC Validator. The HCC Validator uses advanced NLP technology to instantly validate HCC codes against MEAT criteria and issues a clear “Pass” or “Fail” grade. Because it’s SaaS-based, it works with leading EHRs or can be used as a standalone solution. The New Year brings new opportunities and New Year's resolutions. This blog post, the third of its series, will focus on an important topic for those providing services to Medicare Advantage patients: using technology to optimize the HCC documentation process and increasing RAF scores. We will talk about recent updates to the CMS-HCC program, as well as retrospective and prospective approaches toward risk adjustment analytics and coding.
Start Optimal HCC Coding With HCC Assistant in Newton, MAInferscience
Inferscience offers the best HCC coding services in Newton, MA. Your team can analyze patients’ charts and capture HCC codes at the point of care. The HCC Medical Coding Assistant also provides a real-time risk adjustment factor (RAF) score to give you an idea of how the codes selected will impact the RAF score for a patient thereby predicting future funding and expenditures. The HCC Assistant Coder Workflow is a coder-focused version of the HCC Assistant, perfect for provider organizations that have coder assistance. It allows the coder team to pre-select HCC codes for the provider to approve at the point of care. For more information about our HCC coding services, please visit our website or contact us at 617 848 9502.
Using an HCC Coding Tool in your EHR: Instructions with HCC AssistantInferscience
Technology is crucial for your healthcare organization in the new Covid-19 era, as we stated in our earlier blog post. Keeping up with the complex policies and regulations of the CMS is one of the main reasons. For HCC coding to be successful, physicians must report all diagnoses that influence the patient's evaluation, care, and treatment, including coexisting diseases, chronic conditions, and treatments provided, according to an article in ICD Monitoring that was referenced by CMS. For many practices, it might be difficult to provide accurate documentation of all diagnoses on an annual basis; this is where an HCC coding tool can be useful.
Greater Interoperability in Healthcare 2022: Data & TechnologyInferscience
Inferscience offers the best HCC medicare risk adjustment services in Newton, MA. Inferscience has taken advantage of these new wider rules to expand functionality. Inferscience’s proprietary technology can extract clinical data from any web-based EHR and standardize it. The data can be made available to any application via API. It is the expectation that expanding functionality with these types of features will at the end of the day benefit providers and patients as well. The most important consideration, therefore, for the continuing success of this road map is for all interest groups to participate with attentiveness and intentionality. Because in the end, collaboration is the key to greater interoperability in healthcare.
Benefits of Reporting Tools for Risk Adjustment WorkflowsInferscience
Inferscience offers the best medicare risk adjustment coding technology in Newton, MA. The risk adjustment (RA) workflow process in healthcare is here to stay, and even if organizations are slowly catching up, there are a lot of gaps that need to be closed for it to become more efficient. There are several ways to help providers catch up and improve their workflows that will help their health outcome management and, by and large, improve their RAF scores.
Inferscience offers the best HCC Coding Technology in Newton, MA. This PPT post, the third of its series, will focus on an important topic for those providing services to Medicare Advantage patients: using technology to optimize the HCC documentation process and increasing RAF scores. We will talk about recent updates to the CMS-HCC program, as well as retrospective and prospective approaches toward risk adjustment analytics and coding. For more information about our HCC Coding Technology, please visit our website now or contact us at 617 848 9502.
Thoughts on Epic & Cerner's Embrace of 3rd-Party CollaborationInferscience
Inferscience offers the best HCC medical coding and Epic & Cerner EHR clinical support services in Newton, MA. When we launched our Infera Clinical Decision Support system seven months ago, we did so with Allscripts and athenahealth EHRs, because their initial set of APIs made it possible for Infera to harness the rich data from the patient charts to deliver patient-specific clinical recommendations.
What You Need To Know About Infera CDSS For Athenahealth's ClinicalsInferscience
Inferscience offers the best clinical decision support application services in Newton, MA. The Infera clinical decision support application from Inferscience is now available in the Athenahealth Marketplace. It reads structured and unstructured patient data from the EHR, then analyzes the unique details of the patient’s condition against its evidence-based clinical rules, delivering specific care recommendations in real-time. Infera is integrated with Athenaclinicals EHR and is certified by the Athenahealth More Disruption Please (MDP) program.
As a provider, you understand the importance of HCC medical coding. You probably spend a good amount of time making sure you add the correct HCC codes to your documentation and staying up to date with adequate supporting documentation for HCC codes all this to decrease your risk of lower payments, audits, and financial penalties.
Inferscience offers an add-on product to work with the HCC Assistant, the HCC Validator. The HCC Validator uses advanced NLP technology to instantly validate HCC codes against MEAT criteria and issues a clear “Pass” or “Fail” grade. Because it’s SaaS-based, it works with leading EHRs or can be used as a standalone solution. The New Year brings new opportunities and New Year's resolutions. This blog post, the third of its series, will focus on an important topic for those providing services to Medicare Advantage patients: using technology to optimize the HCC documentation process and increasing RAF scores. We will talk about recent updates to the CMS-HCC program, as well as retrospective and prospective approaches toward risk adjustment analytics and coding.
Navigating Challenges in HCC Coding and Risk AdjustmentInferscience
HCC coding processes while not designed to be complex, may not be immediately apparent, making them tedious and time-consuming. Despite its inherent difficulty, the main goal is to provide an accurate and complete overview of each member’s risk profile with the goal of better understanding their health state and being able to predict the cost of care. We also suggest looking into smart HCC Coding and risk adjustment technology, this can help your teams achieve more accurate results and save time. Check out Inferscience’s HCC Assistant to learn more about HCC coding technology that is EHR integrated.
CMS Proposed Interoperability Rule: Where is it at?Inferscience
At Inferscience, we provide different tools to facilitate HCC Coding and Clinical Decision Support for provider organizations. We constantly strive to facilitate documentation for healthcare providers while contributing to better patient care. We want to help provider organizations receive proper credit for the value of care provided.
Solving The Challenge of Real-Time HCC Coding for ProvidersInferscience
HCC (Hierarchical Condition Category) codes are a subset of ICD10 codes that Medicare (and increasingly commercial payers as well) uses to determine the risk scores of Medicare Advantage patients. The sicker the patient, the more HCC codes they have, and the higher the risk score. The higher the risk score is for a patient, the higher the predicted expenditure and therefore the higher the payment to the health plan for that patient.
Reducing Audit Risk with M.E.A.T. Criteria: Valuable Insights and Latest Tech...Inferscience
Inferscience offers HCC coding & risk adjustment services in Newton, MA. In this PPT, we will provide you with valuable information about how to take your HCC coding & risk adjustment to the next level with M.E.A.T. criteria auditing. As a provider, you understand the importance of HCC Coding. You probably spend a good amount of time making sure you add the correct HCC codes to your documentation and staying up to date with adequate supporting documentation for HCC codes all this to decrease your risk of lower payments, audits, and financial penalties.
The Changing Role of the Provider in HCC CodingInferscience
Inferscience offers an HCC Coding tool that integrates with leading EHRs and HIT systems to analyze patient records and claims information to help physicians and coders capture and audit HCC codes within their workflows. This PDF will give detailed information about The Changing Role of the Provider in HCC Coding. With Inferscience’s HCC Assistant, Physicians can document HCC codes and plan of care information in real time during the patient encounter. Now, one solution enables both payers and providers to succeed in today’s value-based care market. For more detail about our services, please visit our website now!
Clinical Decision Support Software Guidelines from the CDS CoalitionInferscience
Inferscience offers the best clinical decision support software guidelines from the CDS coalition services in Newton, MA. As CEO of a startup whose main product provides advanced clinical decision support (CDS), I read with interest the draft guidelines for CDS software that The CDS Coalition came out with recently. I was also curious to see how our application, Infera, stacks up against the guidelines.
CMS Proposed Interoperability Rule: Where is it at?Inferscience
At Inferscience, we provide different tools to facilitate HCC medical coding and Clinical Decision Support for provider organizations. We constantly strive to facilitate documentation for healthcare providers while contributing to better patient care. We want to help provider organizations receive proper credit for the value of care provided. A common obstacle we have encountered is with EHR software integrations, as frequently EHR software companies are not willing to integrate with other companies.
Covid-19 on HCC Risk Adjustment Coding – A Year LaterInferscience
Inferscience HCC coding application helps providers optimize HCC coding and risk adjustment documentation. In this PDF, we will provide you with valuable information about Covid-19 on HCC Risk Adjustment Coding – A Year Later. The pandemic presented many challenges over the past year, including stay-at-home orders that hindered access to healthcare. During the first half of 2020, many providers’ offices closed to all appointments except emergencies, which delayed routine and preventive care for millions of people. Statistics from the end of 2020 show that prospective risk scores used to pay Medicare Advantage (MA) health plans are trending lower than forecasted. HCC Assistant is a cloud-based intelligent HCC coding and billing platform which is integrated with major EHRs.
What CURES ACT Means for Clinicians and Better Technology AutomationInferscience
Inferscience offers the best HCC medical billing and coding services in Newton, MA. In this PDF, we share What CURES ACT Means for Clinicians and Better Technology Automation. There is a plethora of data and information in the health sector, and it keeps growing every day. There is no doubt that adequate health data management is essential to the optimal provision of healthcare services to patients.
Medicare Advantage and HCC Risk Adjustment - InferscienceInferscience
Inferscience offers the best HCC Coding & HCC Risk Adjustment Services in Newton, MA. In this PDF, we share Medicare Advantage and HCC Risk Adjustment. The Medicare Advantage Program, since its inception in 2003, has grown in popularity and has played a crucial role in the delivery of Medicare and reimbursement services to beneficiaries. While various risk assessment models are available in the health sector for risk adjustment assessment, the Medicare Advantage Program maintains the use of the hierarchical condition categories (HCC) coding-based model for the assessment of risk adjustment factor scores in the prediction of healthcare costs for patients. Visit our website for more information about our HCC coding services in Newton, MA.
3 Reasons Why You Need a Software Tool in your HCC Coding Workflow - Infersci...Inferscience
Inferscience offers the best HCC coding software tool services in Newton, MA. In this PDF, we share 3 Reasons Why You Need a Software Tool in your HCC Coding Workflow. A medical billing system is only as strong as its coding system, but as the number of medicare advantage enrollees rises, so does the complexity of claims and code modifications. Many new codes, code modifications, and inactive code changes are introduced each year, making the medical billing process arduous and onerous for even the most experienced coders. Claims are denied or rejected because coding errors might extend your days in A/R, making it more difficult to recover the entire amount you are entitled to. Visit our website for more information about our HCC coding tool services.
Impact of Covid on Healthcare Providers: HCC Medical Billing & Coding OperationsInferscience
Inferscience offers the best HCC medical billing and coding services in the United States. In this PDF, we share all information about the Impact of Covid on Healthcare Providers: HCC Medical Billing & Coding Operations. The situation in the US with COVID-19 has continued to escalate day by day. Healthcare providers are at the front line of this challenging situation that is impacting the healthcare system in unprecedented ways. In these times of uncertainty, healthcare providers have many moving pieces to worry about, today we will focus on the documentation aspects of the novel coronavirus. For more information about our HCC medical billing and coding services, visit our website now.
Why You Need a Software Tool in your HCC Coding WorkflowInferscience
A medical billing system is only as strong as its coding system, but as the number of medicare advantage enrollees rises, so does the complexity of claims and code modifications. Inferscience provides the HCC Coding Software designed to give real-time HCC coding guidance to providers and coders in their workflow within the EHR, HCC Assistant. We have 12 years of experience working with electronic health records. For more information, visit our website.
Impact of Coronavirus on HCC Billing and Coding.pdfInferscience
The COVID-19 outbreak is key to keeping hospitals and practices running and ready for patients. When it comes to billing, it is Important to consider some Changes that apply to medicare coverage specific to COVID-19. A big concern for the senior population regarding the coronavirus is Medicare coverage. if you’re a healthcare provider looking for an HCC billing and coding Technology, tools you can visit our website
HCC Coding and Risk Adjustment Tool model is specially designed to estimate future health care costs for patients. its main objective is to consider the well-being of the executives alongside exact repayments from medicare Advantage Plans.
Reducing Audit Risk with M.E.A.T. Criteria - InferscienceInferscience
In today’s blog, we will provide you with valuable information about how to take your HCC & risk adjustment coding to the next level with M.E.A.T. criteria auditing Following M.E.A.T. criteria standards ensures healthcare provider organizations, coding companies, practice management consultants, and revenue cycle companies regularly monitor and audit for correct HCC coding. for more information do visit our site: https://bit.ly/39DSUih
Navigating Challenges in HCC Coding and Risk AdjustmentInferscience
HCC coding processes while not designed to be complex, may not be immediately apparent, making them tedious and time-consuming. Despite its inherent difficulty, the main goal is to provide an accurate and complete overview of each member’s risk profile with the goal of better understanding their health state and being able to predict the cost of care. We also suggest looking into smart HCC Coding and risk adjustment technology, this can help your teams achieve more accurate results and save time. Check out Inferscience’s HCC Assistant to learn more about HCC coding technology that is EHR integrated.
CMS Proposed Interoperability Rule: Where is it at?Inferscience
At Inferscience, we provide different tools to facilitate HCC Coding and Clinical Decision Support for provider organizations. We constantly strive to facilitate documentation for healthcare providers while contributing to better patient care. We want to help provider organizations receive proper credit for the value of care provided.
Solving The Challenge of Real-Time HCC Coding for ProvidersInferscience
HCC (Hierarchical Condition Category) codes are a subset of ICD10 codes that Medicare (and increasingly commercial payers as well) uses to determine the risk scores of Medicare Advantage patients. The sicker the patient, the more HCC codes they have, and the higher the risk score. The higher the risk score is for a patient, the higher the predicted expenditure and therefore the higher the payment to the health plan for that patient.
Reducing Audit Risk with M.E.A.T. Criteria: Valuable Insights and Latest Tech...Inferscience
Inferscience offers HCC coding & risk adjustment services in Newton, MA. In this PPT, we will provide you with valuable information about how to take your HCC coding & risk adjustment to the next level with M.E.A.T. criteria auditing. As a provider, you understand the importance of HCC Coding. You probably spend a good amount of time making sure you add the correct HCC codes to your documentation and staying up to date with adequate supporting documentation for HCC codes all this to decrease your risk of lower payments, audits, and financial penalties.
The Changing Role of the Provider in HCC CodingInferscience
Inferscience offers an HCC Coding tool that integrates with leading EHRs and HIT systems to analyze patient records and claims information to help physicians and coders capture and audit HCC codes within their workflows. This PDF will give detailed information about The Changing Role of the Provider in HCC Coding. With Inferscience’s HCC Assistant, Physicians can document HCC codes and plan of care information in real time during the patient encounter. Now, one solution enables both payers and providers to succeed in today’s value-based care market. For more detail about our services, please visit our website now!
Clinical Decision Support Software Guidelines from the CDS CoalitionInferscience
Inferscience offers the best clinical decision support software guidelines from the CDS coalition services in Newton, MA. As CEO of a startup whose main product provides advanced clinical decision support (CDS), I read with interest the draft guidelines for CDS software that The CDS Coalition came out with recently. I was also curious to see how our application, Infera, stacks up against the guidelines.
CMS Proposed Interoperability Rule: Where is it at?Inferscience
At Inferscience, we provide different tools to facilitate HCC medical coding and Clinical Decision Support for provider organizations. We constantly strive to facilitate documentation for healthcare providers while contributing to better patient care. We want to help provider organizations receive proper credit for the value of care provided. A common obstacle we have encountered is with EHR software integrations, as frequently EHR software companies are not willing to integrate with other companies.
Covid-19 on HCC Risk Adjustment Coding – A Year LaterInferscience
Inferscience HCC coding application helps providers optimize HCC coding and risk adjustment documentation. In this PDF, we will provide you with valuable information about Covid-19 on HCC Risk Adjustment Coding – A Year Later. The pandemic presented many challenges over the past year, including stay-at-home orders that hindered access to healthcare. During the first half of 2020, many providers’ offices closed to all appointments except emergencies, which delayed routine and preventive care for millions of people. Statistics from the end of 2020 show that prospective risk scores used to pay Medicare Advantage (MA) health plans are trending lower than forecasted. HCC Assistant is a cloud-based intelligent HCC coding and billing platform which is integrated with major EHRs.
What CURES ACT Means for Clinicians and Better Technology AutomationInferscience
Inferscience offers the best HCC medical billing and coding services in Newton, MA. In this PDF, we share What CURES ACT Means for Clinicians and Better Technology Automation. There is a plethora of data and information in the health sector, and it keeps growing every day. There is no doubt that adequate health data management is essential to the optimal provision of healthcare services to patients.
Medicare Advantage and HCC Risk Adjustment - InferscienceInferscience
Inferscience offers the best HCC Coding & HCC Risk Adjustment Services in Newton, MA. In this PDF, we share Medicare Advantage and HCC Risk Adjustment. The Medicare Advantage Program, since its inception in 2003, has grown in popularity and has played a crucial role in the delivery of Medicare and reimbursement services to beneficiaries. While various risk assessment models are available in the health sector for risk adjustment assessment, the Medicare Advantage Program maintains the use of the hierarchical condition categories (HCC) coding-based model for the assessment of risk adjustment factor scores in the prediction of healthcare costs for patients. Visit our website for more information about our HCC coding services in Newton, MA.
3 Reasons Why You Need a Software Tool in your HCC Coding Workflow - Infersci...Inferscience
Inferscience offers the best HCC coding software tool services in Newton, MA. In this PDF, we share 3 Reasons Why You Need a Software Tool in your HCC Coding Workflow. A medical billing system is only as strong as its coding system, but as the number of medicare advantage enrollees rises, so does the complexity of claims and code modifications. Many new codes, code modifications, and inactive code changes are introduced each year, making the medical billing process arduous and onerous for even the most experienced coders. Claims are denied or rejected because coding errors might extend your days in A/R, making it more difficult to recover the entire amount you are entitled to. Visit our website for more information about our HCC coding tool services.
Impact of Covid on Healthcare Providers: HCC Medical Billing & Coding OperationsInferscience
Inferscience offers the best HCC medical billing and coding services in the United States. In this PDF, we share all information about the Impact of Covid on Healthcare Providers: HCC Medical Billing & Coding Operations. The situation in the US with COVID-19 has continued to escalate day by day. Healthcare providers are at the front line of this challenging situation that is impacting the healthcare system in unprecedented ways. In these times of uncertainty, healthcare providers have many moving pieces to worry about, today we will focus on the documentation aspects of the novel coronavirus. For more information about our HCC medical billing and coding services, visit our website now.
Why You Need a Software Tool in your HCC Coding WorkflowInferscience
A medical billing system is only as strong as its coding system, but as the number of medicare advantage enrollees rises, so does the complexity of claims and code modifications. Inferscience provides the HCC Coding Software designed to give real-time HCC coding guidance to providers and coders in their workflow within the EHR, HCC Assistant. We have 12 years of experience working with electronic health records. For more information, visit our website.
Impact of Coronavirus on HCC Billing and Coding.pdfInferscience
The COVID-19 outbreak is key to keeping hospitals and practices running and ready for patients. When it comes to billing, it is Important to consider some Changes that apply to medicare coverage specific to COVID-19. A big concern for the senior population regarding the coronavirus is Medicare coverage. if you’re a healthcare provider looking for an HCC billing and coding Technology, tools you can visit our website
HCC Coding and Risk Adjustment Tool model is specially designed to estimate future health care costs for patients. its main objective is to consider the well-being of the executives alongside exact repayments from medicare Advantage Plans.
Reducing Audit Risk with M.E.A.T. Criteria - InferscienceInferscience
In today’s blog, we will provide you with valuable information about how to take your HCC & risk adjustment coding to the next level with M.E.A.T. criteria auditing Following M.E.A.T. criteria standards ensures healthcare provider organizations, coding companies, practice management consultants, and revenue cycle companies regularly monitor and audit for correct HCC coding. for more information do visit our site: https://bit.ly/39DSUih
Reducing Audit Risk with M.E.A.T. Criteria - Inferscience
Driving Provider Engagement in HCC Coding and Risk Adjustment - Inferscience
1. Driving Provider Engagement in HCC Coding
and Risk Adjustment
Although revenue from risk-based contracts continues to increase for medical groups of
all sizes, motivating providers to fully participate in their organization’s risk adjustment
efforts remains a challenge for healthcare organization leaders. Because of this, many
organization leaders have started looking for different ways to motivate their teams of
providers to drive better engagement in HCC Coding & risk adjustment documentation.
In our first blog post of this series, we discussed the importance of HCC coding and
optimal documentation, its challenges, and the role of the individual provider.
In this blog post, we look at steps that healthcare organization leaders can take to help
ease the documentation burden on clinicians, maintain team motivation, and ultimately
improve the organization’s HCC coding practices and bottom line.
Making HCC Coding Easier: Start with the Right Tools
Managing the complexities of risk adjustment documentation is difficult without the use
of technology. When clinicians aren’t equipped with the right analytics, coding, and
documentation tools, medical groups are at risk for underpayments or lost revenue
through clawbacks. Although provider organizations usually turn to their EHR for risk
adjustment solutions, many EHR companies have been slow to optimize provider
workflows to assist with HCC coding and documentation. Further complicating the issue
2. are EHRs that block the free exchange of information, and offer little to no clinical
support.
All of that is changing, however. Although EHRs are beginning to offer native HCC
coding functionality, it’s important to keep in mind that EHRs are primarily charting tools,
not purpose-built analytics and coding platforms.
To make clinical documentation easier for providers, it is essential to equip providers
with the right HCC coding tools. Since EHRs to this date don’t provide enough
functionality for optimal HCC coding, it has become necessary to add tools that will
automate the process and increase documentation accuracy. An EMR-integrated tool
such as Inferscience’s HCC Assistant is ideal.
The HCC Assistant analyzes both clinical and claims information to provide clinicians
with HCC coding guidance based on a 360-degree view of the patient’s condition. The
HCC Assistant’s NLP-based rules engine performs a prospective analysis of patient
information found within the EHR, as well as a retrospective analysis of submitted
medical claims, to instantly identify and close HCC coding gaps. The platform also
performs real-time risk adjustment factor (RAF) scoring to suggest how codes selected
can impact the RAF score for a patient, thereby predicting future funding and
expenditures. Inferscience’s most robust integration for the HCC Assistant is with
athenaClinicals, but the platform integrates with Dr. Chrono and Allscripts EHR as well.
Having the right tools is one of the most important ingredients for a perfect HCC Coding
recipe, but this ingredient won’t be enough without internal practice contribution to try to
keep providers engaged in HCC coding improvements, so, how do we motivate
providers to participate in HCC Coding & HCC Risk Adjustment?
Motivation is Key
One of the most important aspects of driving providers’ engagement in HCC coding
documentation is keeping the team motivated as well. We put together a few motivation
tactics that are working for different healthcare organizations:
1. Accountability:
To maintain accountability, Health Catalyst suggests driving HCC coding improvement
with the use of interdisciplinary workgroups. Workgroups can be formed with members
of the analytics team, clinicians, clinic managers, operations, and medical coders. The
use of interdisciplinary groups provides an easy teamwork solution to make sure
everyone is keeping each other accountable to improve the practice’s HCC coding as a
whole. A great addition to interdisciplinary workgroups can be assigned a practicing
Physician Advisor. The Record magazine suggests assigning a Physician Advisor with a
good relationship with the medical staff, good communication skills, and proper
documentation skills can positively impact documentation behavior for provider teams
and keep them motivated to follow best documentation practices.
3. 2. Inform and Educate:
It is important to keep your team informed about the current CMS regulations and
proposed rule changes, as well as educate them about any new tools you decide to
incorporate. For example, an organization using the HCC Assistant can provide
education sessions on the benefits of using the tool, as well as different “how-tos” when
using the HCC Assistant.
3. Incentivizing:
As mentioned in an article by AAFP, “Hospital, group, and health system employers
increasingly are paying physicians based on how their system performs in value-based
care. In this environment, risk adjustment can greatly affect physician income, so it is
important to get it right.” When incentives are provided it is easier to see a clear and
immediate result of hard work. This can also lead to an impact on the patient. Douglas
Conrad explains in his article in Health Services Research, based on empirical
research, that value‐based adjunct compensation incentives place a strong emphasis
on patient experience.
Maintain Engagement
If you provide the right tools and apply the recommended motivation tactics, it is
important to maintain provider engagement by measuring results (data & more data!).
You will need to provide weekly or monthly reports and feedback to your team to
analyze not only what is improving but what needs improvement as well. Following an
approach of analysis, planning and execution can help you achieve better goals for your
team.
Following the suggested techniques will not only benefit healthcare organizations but
patients and payers as well, as the risk adjustment model is a cycle that affects or
rewards everyone involved. These are some of the steps we recommend you follow to
make provider’s HCC coding & documentation easier, keep them motivated and
maintain engagement. In our last blog post of the series, we will focus solely on
providing guidance, useful information, and the differentiation between tools that are
used to improve HCC coding.