Identifying HCC Gaps Before They Cost You: A Vendor-Driven Informatics Approach to Audit Mitigation
Medicare Advantage Organizations (MAOs) face growing demands to ensure accurate Hierarchical Condition Category (HCC) coding, particularly under the scrutiny of RADV Audits in Risk Adjustment. These audits, conducted by the Centers for Medicare & Medicaid Services (CMS), verify diagnosis codes against medical records to ensure compliance and recover overpayments. Inaccurate HCC coding can lead to […]
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