The Hierarchical Condition Categories or HCCs are the new reimbursement methodology to which you must quickly adapt as an HIM professional. HCCs are different than DRGs and E&M levels. You need to know how they are different and what documentation qualifies to be used for assigning codes for claims. You need to know what must be present in the medical record documentation to permit a condition to be reported on the claim. And not knowing will impact your medical staff profiles upon which their reimbursement is based. So you need to know.
And this webcast will help you— especially if your facility is participating in a risk-based plan in collaboration with Medicare Advantage, where sharing of the profits (or losses) are based on the coding and quality of care, measured by the outcomes and costs.
From this important webcast you will...
- Understand the components of an HCC, distinguish between related and unrelated conditions, and the role of chronic conditions.
- Recognize that the role of the coder will change in an HCC reimbursement environment and what must be present in the medical record documentation to permit a condition to be reported on the claim.
- Learn how the CMS HCCs and HHS HCCs differ and how the payments for HCCs are administered and when they are recalibrated.
- Distinguish between the types of external auditors that assess the validity of the claim data and codes submitted by providers through the health plans.
- List actions that can be taken to enhance clinical documentation that supports the care provided for the patient's conditions.