HCC Coding Service Scope
We support retrospective chart review, prospective pre-visit planning and concurrent in-visit coding workflows depending on the practice's contract structure and EHR setup.
- Retrospective chart review across prior-year encounters
- Prospective pre-visit suspect lists for known chronic conditions
- Concurrent point-of-care coding support
- MEAT documentation validation on each captured HCC
- Chronic condition recapture planning across the calendar year
- Audit-ready rationale captured for each HCC assignment
Compliance and Documentation Standards
RAF accuracy is meaningless if it cannot withstand a RADV or OIG audit. Every HCC we capture is supported by documentation that satisfies MEAT criteria; suspect codes without supporting documentation are returned to the provider as queries rather than coded.
- MEAT validation on each chronic condition
- Provider documentation queries for unsupported suspects
- Specificity coding aligned to ICD-10-CM Official Guidelines
- Audit-trail documentation for RADV defensibility
How HCC Coding Affects Revenue
Under-coding chronic conditions understates patient acuity and depresses risk-adjusted payment; over-coding without documentation creates audit exposure. Our role is to deliver accurate RAF capture — neither inflated nor deflated — and to give the practice clear visibility into the chronic condition recapture rate.
Measurable Outcomes Our Clients Track
- Accurate RAF score capture aligned to documentation
- Improved chronic condition recapture rate year over year
- Reduced suspect codes without MEAT support
- Audit-defensible coding rationale on every HCC
- Better visibility into patient population acuity
- Documentation queries returned to providers in agreed cadence
Discuss Your Revenue Cycle Goals
Speak with our team about how hcc coding services can be structured around your specialty, payer mix and current performance benchmarks.
Contact Our Team