Innovative outreach and engagement solution increases Medicare Advantage HCC coding
Medicare Advantage (MA) plans rely on risk adjustments within their member population to accurately reflect reimbursements. Members with one or more improperly coded or missing hierarchical condition categories (HCC) means less reimbursement revenue for that patient population.
Having reimbursement properly reflect the risk of a MA population is an important objective for health plans. Using a systematic process powered by advanced analytics is an important strategy health plans can deploy to achieve such objectives.