Our Services

HCC Coding Services

In today's ever-evolving healthcare landscape, the adoption of value-based payment structures is paramount. At the heart of this transformative shift lies Hierarchical Condition Category (HCC) coding, an indispensable tool for navigating the complexities of modern healthcare. Originally conceived to estimate future healthcare costs for patients, HCC coding has emerged as a pivotal mechanism for forecasting.

As healthcare providers and organizations aspire to deliver more efficient, cost-effective, and patient-centered care, the role of HCC coding services provided by Global Healthcare Services becomes increasingly vital. In this dynamic environment, we are dedicated to enhancing the accuracy and effectiveness of HCC coding, ensuring that healthcare providers can better anticipate and address the needs of their patients while achieving financial sustainability.

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OUR Expertise

HCC Coding

Comprehensive Risk Adjustment Solutions : Our suite of Risk Adjustment solutions is designed to boost the performance of Health Plans. Through retrospective chart audit services, we meticulously review medical records to identify inaccuracies such as incorrectly coded, uncoded, or under-coded charts.

Strategic Risk Adjustment Support : We go beyond coding to assist Health Plans in formulating effective risk adjustment strategies.

Specialization in Medical Record Audits : Medical record audits are at the core of our services. We excel in conducting retrospective chart reviews and thoroughly examining medical records for accuracy and completeness.

RADV Audits : Our proficiency extends to audits of RADV, an essential component of risk adjustment in healthcare. We rigorously review and validate data to ensure compliance with CMS requirements and official coding standards.

Our Services

HCC Coding Services

Chart Audits
HCC Value
CMS Compliance
Error Identification
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    Comprehensive Chart Audits

    Our team consists of certified coding experts who are well-versed in conducting compliance audits and performing thorough chart reviews. We meticulously examine medical records to ensure that all coding is accurate and in alignment with the latest regulations and guidelines.

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    HCC Value Optimization

    Our primary goal is to achieve the correct Hierarchical Condition Category (HCC) value for each Medicare Risk Adjustment (MRA) diagnosis code. This involves a systematic and precise approach to coding, which not only helps in accurate risk assessment but also supports efficient resource allocation within healthcare organizations.

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    CMS Standards Compliance

    We take pride in our unwavering commitment to adhering to the standards and requirements set forth by the Centers for Medicare & Medicaid Services (CMS). Our coding practices align with CMS's risk adjustment reporting guidelines and official coding standards to guarantee compliance at all levels.

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    Error Identification

    Our dedicated team pays meticulous attention to detail when reviewing medical records. We specialize in identifying missed diagnoses and errors, ensuring that all relevant information is accurately documented and coded. This proactive approach helps healthcare providers maximize their revenue potential while maintaining regulatory compliance.

Our HCC Coding Services Delivery Model

HCC Coding Services

Dedicated Account Managers : We provide dedicated account managers to ensure seamless communication and support.

Certified HCC Coders : We maintain one of the largest pools of certified HCC coders to ensure the highest quality of service.

Comprehensive Reporting : We offer detailed and comprehensive reporting to keep you informed and in control.

Unmatched HCC Expertise : With years of experience and expertise in HCC coding, we are well-equipped to meet your needs.

Payment Condition Count Model : This accounts for 50% of the calculation and considers the number of medical conditions for each patient.

Risk Adjustment Criteria : Accounting for the remaining 50%, this component considers the RAF score of each patient.

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