Risk Score is Wrong if Codes Not Sent

Risk Score is Wrong if Codes Not Sent

Kris Gates Kris Gates

Kris Gates

Founder of Preventive Pay

发布日期: 2020年2月14日
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Not capturing ICD10 codes at the payor level results in a lower HCC score for the patient and lower financial benchmark for the patient, provider, facility and ACO.

Why?

The financial benchmark is calculated using the HCC risk score. If the risk score is wrong, then the financial benchmark is wrong.

Problem to Solve?

Diagnoses not being sent to the payor, such as Medicare. If not sent and received by the payor, then not included in the risk score and financial benchmark calculation.

It takes minimum of 12 months for this change to positively impact your benchmark.

Every clinic should compare EHR records to Medicare patient data for 10 Charts.

Many ACOs have encountered and fixed this issue.

HCC Code Capture

Join us February 26th!

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Kris Gates [email protected] 480.659.8130

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