HCC Coding Services and 360° Performance Evaluation
HCC-Coding Services assist in completing submissions to RAPS/EDPS ahead of the required deadlines. We perform proxy or mock Risk Adjustment Data Validation (RADV) audits, similar to CMS-RADV Audit Contractors, to identify vulnerabilities in real-time audits and suggest actions to ensure compliance with relevant regulations.
This initiative helps Medicare Advantage Organizations (MAOs) track their potential liabilities for penalties and sanctions that could result from real-time audits. Additionally, we conduct a comprehensive 360° performance evaluation of:
- Panel providers to ensure proper Clinical Documentation and Coding team performance for accuracy in the coding process
- Communication between Clinicians and Coders to verify the appropriateness of the prescribed PQP
- Data Submissions Team to ensure timely submission of coding data to RAPS/EDPS
- Patient Encounters to ensure proper follow-up with patients to maintain their health and continued enrollment in the plan
- We also provide 4-Star Rating and HEDIS Data Abstraction Services to help you qualify for the Quality Performance Bonus (QPB) and achieve a 4/4 star rating