HCC/MRA Coding – Risk adjusted reimbursement

No longer only for Medicare Advantage plans, Hierarchal Condition Category (HCC) coding plays a very important role in today’s world of value-based care

Subsero Health possesses a high degree of expertise of related to HCC/MRA coding especially as it relates to assisting in documenting additional risk-based reimbursements for the illness burden of a particular patient rather than for quantity of services rendered. This area is often overlooked as we see how chronic conditions that might be managed by a specialist, often get completely left out of the PCP documentation. We make sure that our provider partners are assessing chronic conditions often and regularly, and so that documentation can be coded for capture of these conditions. With the implementation of ICD-10 this has drastrically increased the complexity for providers and payers to accurately assess the risk of the population.