7 TIPS TO CLOSE

HCC CODING GAPS

Completely documenting and capturing HCC codes will ensure accurate risk
adjustment scores—and correct and complete payer allocations.

1 Put the right team in place

Taking on risk and managing a
patient population is a team sport.
Make sure the providers are
getting the support they need to
succeed. Consider adding support
staff such as HCC coders, nurse
navigators, and care coordinators
to assist.

2 Prep for patient

visits ahead of time
Help providers
identify patients
with HCC conditions
ahead of their visits
with activities such
as chart prep,
problem list
reviews, and
morning
huddles.

3 See your patients

at least once a year
Diagnosis codes must be
captured through face-to-
face encounters and
X reported annually. Plan
early—and create robust
outreach plans.

4 Use better forms

To make sure that valid
diagnosis codes are
documented at the time
of the visit, consider
options such as Patient
Assessment Forms
(PAFS) or Comprehensive
Health Assessments
(CHAs).

5 Automate the chart

review process
Use technology to automatically
identify high-value encounters
requiring coder review, streamline
your workflow, and ensure that
HCC coding is completed
prior to claim submission.

6 Identify success metrics

Identify the metrics and data
that define success, such as:
o HCC recapture rate
(by location and provider)
o Trending of patient risk
adjustment scores

Give your providers

7 regular feedback
Educate providers on their
performance in capturing
HCCs and create a plan on
how to improve.

Learn how RCxRules can help improve your organization’s HCC capture rate and
improve the accuracy of your risk scores. Visit www.rcxrules.com/hcc-coding-software.