Help Increase HCC Coding Accuracy, Efficiency
and the Bottom Line at the Point of Care
Our Clinical Decision Support (CDS) can help organizations capture hierarchical condition category (HCC) codes by implementing alerts to prompt providers to add the necessary codes in the electronic health record (EHR) workflow. The goal of HCC documentation is to capture a patient’s true clinical picture and achieve accurate risk scores while providing high-level care. The HCC guidance is designed to be actionable, and is built to limit the provider’s administrative burden and ensure accurate reimbursement.
Community Health Network Sees Financial Impact of More Than $13 Million1,2
Current HCC Coding Approach
- Manual processes
- Pulling charts ahead of a patient visit to look for conditions that should be captured
- Sticky note reminders
- Retrospective review after the visits
New HCC Approach
A Better Way
- Real-time, software using chart data
- Automatic during the encounter
- Recommendations delivered based on chart evidence at the right time in the clinicians existing electronic health record (EHR) workflow
Only alerted when there is a suggestion that may
help guide the provider to improve coding accuracy.
With HCC Tech, Bellin Health Improves RAF Score by 16 Percent3
“I either need to continue doing what I’m doing and performing at the level I’m performing, or I need to change something. For me, the change was incorporating HCC capture into the workflow.”
Dr. Shane Degen – Assistant Medical Informatics Officer, Bellin Health
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Actionable HCC Alerts help providers identify new codes not previously documented.
Benefits of HCC Alerts
Available in EHR Workflow
Actionable HCC alerts are made available in the EHR at the point of care and are designed to assist a provider in identifying whether a new or different HCC code should be considered by a provider to optimize diagnosis coding.
Suggests New Codes
Our HCC alerts are not solely reliant on prior coding history, nor do they focus primarily on the recapture of codes. This helps enable providers to identify new codes that have not been previously documented by providers, which may result in a year-over-year increase in RAF scores.
Expanded HCC Content
We offer more than 40 HCC alerts covering a variety of conditions including diabetes, Alzheimer’s disease, benzodiazepine and opioid dependence, chronic kidney disease and more that can be made available as part of your clinical decision support (CDS) library.
Actionable Alerts
The alerts are designed to be actionable within the EHR workflow and built to limit the provider’s administrative burden by avoiding the need to remember to update the code later or navigate to a different part of the EHR to complete the task.
Provider Efficiencies
The alerts are designed to increase provider efficiencies across the care continuum, with the goal to help improve patient care, risk score outcomes, billing compliance and the potential to optimize Medicare Advantage reimbursement.AI-enabled, Evidence-based Solutions
Designed by Clinicians
Bon Secours Mercy Health Improves HCC Coding Accuracy
Documented over 35,000 HCC categories in just six months.4
“I came to the table as a skeptic. My initial reaction was that the alerts are too much of an ask on the provider. But the data was what really convinced me. We are seeing high follow rates of these alerts from providers which is extraordinary. It exceeded all expectations.”
Mark Binstock – Chief Medical Information Officer, Bon Secours Mercy Health
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What Can Our HCC Solution Do For You?
Resources
See How Community Health Network Saw Financial Impact of $13 Million
Helps Bellin Health Improve RAF Score by 16 Percent
in Six Months Leading to a Significant Financial Impact
Gain Insights on the Multi-Million Dollar Financial Impact.