How an HCC Coding Audits Partner Can Help Your Facility

How an HCC Coding Audits Partner Can Help Your Facility

Reducing your risk of inaccurate HCC coding and compliance issues begins with an efficient HCC auditing partner. An external HCC auditing consultant, like YES HIM Consulting, can conduct regular coding audits to identify incorrect coding situations, overpayments, and gaps in your coding processes or documentation before governmental or payer organizations flag them.

Evidence from MedPAC, the GAO, and other organizations shows that Medicare Advantage plans are being overpaid. As a result, CMS will enact a series of policies over the next decade to adjust for coding intensity and deliver more accurate payments. So, more than ever, conducting thorough HCC audits to pinpoint non-compliant practices is crucial.

The price of non-compliance is high. Not only could your bottom line suffer financially, but your organization’s reputation may also be damaged beyond repair. That is why an HCC coding audits partner is essential.

HCC Chart Review – An Overview

hcc coding audits

YES’ HCC audit process begins with a review of your HCC codes to ensure the documentation supports the assignment. Our subject matter experts will flag any codes that may be inaccurately assigned or need additional supporting documentation. The consultants provide additional HCC diagnoses recommendations based on documentation so that the HCC coding process is complete and accurate.

One of the main benefits of securing YES as your HCC audit partner is the training and education provided as part of our services. During the audit process, YES consultants pinpoint problem areas that need additional attention, and could be addressed with the proper education plan. YES has a dedicated in-house education team to develop a customized education session based on your organization’s audit findings.

Using decades of combined experience, our coders and auditors can navigate the complex process of identifying the correct HCC code assignments, then train clinicians in appropriate documentation practices in order for the coders to select the right HCC diagnoses for proper reporting and reimbursement in the future. Understanding HCC codes and how to assign them based on adequate documentation can be a confusing process, so having the assistance of a well-trained team of consultants is just another benefit of a trusted HCC audit partner.

Why Are Trending Reports Essential?

Ongoing audits provide frequent data that can offer trends and insights captured in Audit Trending Reports. YES Trending Reports allow the client to be able to track and review the statistics they need most.

If you’re interested in working with a trusted HCC audit partner, contact YES today to learn how our team can help you.

Karen Youmans

Karen G. Youmans, MPA, RHIA, CCS – President, YES HIM Consulting, Inc. AHIMA-approved ICD-10-CM/PCS trainer
HCC coding audits

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