The RCxRules Blog

How to Succeed in Value-Based Care Without In-House HCC Coders

HCC coders are a crucial part of identifying revenue opportunities in value-based care. So what to do if your organization isn’t ready for an in-house coding staff? Whether it’s due to budget deficits, lack of infrastructure, or an inability to hire and retain coding experts in today’s challenging staffing environment, many groups have to find other ways to navigate the intricacies of HCC coding and improve RAF score accuracy.

HCC coding is complex—there are over 70,000 ICD-10 codes, roughly 9,500 of which map to 86 HCC conditions with 19 varying categories. Physicians didn’t go to medical school to memorize codes and keep up to date with ever-changing regulations—their focus is on providing the best possible care to their patients. This means that physicians are often much better at clinical documentation than HCC coding, and a gap can form between the two. For many organizations, in-house HCC coders are the way to close this gap.

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Groups that don’t have in-house coders (or have too few coders for their current workload) may need to turn to outside resources to improve RAF score accuracy. The AAPC + RCxRules Advanced HCC Coding Managed Service offers access to highly trained coders plus automation technology that helps them work even more efficiently.

By leveraging outside talent, an organization can reap the benefits of an in-house coding team without having to create the internal infrastructure. This also allows medical groups to fast-track what could be a lengthy hiring, onboarding, and training process for an in-house coder (or team of coders). Organizations that may be too small to hire a dedicated coder can still improve RAF score accuracy and capture missed revenue without needing to budget for a full-time employee.

The Best Talent and Technology

AAPC is widely recognized as the gold standard in medical coding. By combining AAPC CRCs with AI technology from RCxRules that automatically finds encounters that have been well documented but inaccurately coded, you can dramatically improve RAF score accuracy.

This managed service has a risk-free pricing model, meaning medical groups only pay for codes that are added, modified, or deleted. Schedule a 15-minute meeting to learn more.

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