Providers went to medical school to become doctors, not coders. They excel at providing patient care, but often struggle to translate the care provided into HCC codes. To combat this, many medical groups implement measures to provide HCC coding support to their providers.
Pre-visit planning, education initiatives, and EMR alerts are activities that can help providers succeed at HCC Coding. However, effectively measuring these activities can be a significant challenge. Whether it’s a lack of reporting capabilities or a significant lag time between implementing changes and receiving objective feedback, medical groups often struggle to quantify the success of these provider-focused HCC coding support programs.
The RCxRules HCC Coding Engine measures and manages provider support activities in real time. RCxRules’ standard reporting tracks both provider HCC capture and coder HCC capture after a visit is complete but before a claim goes to the payer. The solution is also able to bring in third party data— from a Medicare Advantage plan, for instance—so users can see the same data as the providers.
As an example, if a group is implementing pre-visit planning and identifies three “suspect” HCC codes to add to an EMR alert, the HCC Coding Engine can take a feed from the system generating the three “suspect” codes and track what the provider captures. With this report, HCC coding leadership easily sees a provider’s capture and recapture rates so they can determine if further education or planning is needed.
To learn more about support provider-facing activities with the HCC Coding Engine, set up a 1:1 meeting today.