How HCC Medical Coding Can Turn Your Healthcare Organization Into a Profitable One

How HCC Medical Coding Can Turn Your Healthcare Organization Into a Profitable One

Hierarchical condition category (HCC) medical coding is a risk adjustment process that utilizes ICD-10 codes to assign risk values, or RAF scores, for each patient. This process calculates the patient’s future cost of healthcare and the appropriate amount of Medicare coverage for the following year1.

hcc medical

The cost of inaccurate HCC medical coding is detrimental to an organization’s bottom line. Without a true assessment of the patient’s care, the hospital’s reimbursement is lower, leaving money on the table. In addition, if coders fail to capture all the HCC codes in the patient’s record, the individual could receive incomplete care. As a result, both the patient and the facility suffer.

The Profitable Benefits of an HCC Coding Solution

In some cases, healthcare organizations cannot dedicate the time, money, or training to improving their HCC coding process. That’s where a healthcare coding consulting firm comes in.

An external HCC coding consultant has the designated resources and expertise it takes to fully train coding teams in accurately capturing HCC codes. Not only are they current on the latest coding updates, an HCC consultant actively practices HCC coding in their daily operations.

Entrusting the HCC medical coding process to a qualified external vendor helps build a complete, accurate record of the patient’s health. The RAF score provides a complete picture of each patient, including their diagnoses, diseases, and the amount of risk they represent. As a result, the coder accurately assigns the HCC codes and RAF score according to the documentation, leading to higher reimbursement for the organization.

With a full picture of the patient available, the organization’s care team can deliver the best experience possible. Each team member in the organization, including the physicians, nurses, HIM professionals, and top executives, works together seamlessly to deliver top-of-the-line care. No patient will slip through the cracks that can arise from incomplete documentation and records.

Furthermore, the practice can stay competitive in the market since they have an accurate value of the care they provide. Setting a true cost benchmark helps the organization save money down the line, as well as allows executives to correctly budget for the fiscal year to come.

YES HIM Consulting has a qualified team of coders who can help healthcare organizations identify more HCC codes and increase their reimbursements. In addition, YES consultants can train clients’ in-house teams on HCC coding to streamline the process for the future.

Contact YES today to discuss our HCC medical coding, consulting, and training options.


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Mari Cely

Director, Business Strategy & Client Services
HCC medical

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