by Matt Peterson, EVP Client Success and Growth | Feb 12, 2021 | Payers
Hierarchical Condition Categories and How They Affect Reimbursement Hierarchical Condition Category coding — or HCC coding — was implemented by the Centers for Medicare and Medicaid Services (CMS) in 2004 to help estimate the healthcare costs of Medicare enrollees in...
by Matt Peterson, EVP Client Success and Growth | Feb 12, 2021 | Payers
What Is Risk Adjustment? Risk adjustment is an annual process that is used to appropriately compensate health plans for the costs associated with taking on members with chronic health conditions. With risk adjustment, if your health plan serves a higher than average...
by Matt Peterson, EVP Client Success and Growth | Sep 25, 2020 | Payers, Security & Compliance
Additional reconciliation run for CMS PY2020 Risk Adjustment data submission allows more time to close gaps and increase submission accuracy On September 18, 2020, the Department of Health and Human Services Centers for Medicare & Medicaid Services issued the...
