PINC AI™ Stanson's 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. CodingGuide offers HCC guidance designed to be actionable and is built to limit the provider’s administrative burden and ensure accurate reimbursement.
The Centers for Medicare & Medicaid Services (CMS) 2023 updates have significantly impacted the healthcare industry, particularly in coding and reimbursement processes. The HCC V28 updates have changed HCC code naming and numbering, adjustments to HCC coefficient values, expanded condition mapping and an increased consideration of conditions for risk adjustment. These modifications heighten the importance of accurate coding for financial outcomes of providers and payers. Stanson’s HCC CodingGuide serves as a dependable technology solution in this dynamic landscape.
We're addressing some of the common [HCC] barriers including provider engagement, avoiding burnout, fatigue, and how the Stanson solution helped us meet some really unaddressed needs.
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 to optimize diagnosis coding.
Suggests New Codes
With CodingGuide, 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 Risk Adjustment Factor (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.
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.
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.
Support for Significant CMS HCC V28 Updates
Our coding system offers a streamlined, user-friendly interface, effectively identifying all relevant HCCs, including the removal of over 2,000 diagnostic codes and adding over 200 diagnosis codes that do not map to payments in V24. CodingGuide can help navigate V28 coding changes and enhance risk score accuracy and optimize reimbursement.
We were hitting 40 percent response rates on these alerts, which is high, and I didn’t receive any complaints from providers.
Our clients have found tremendous success in PINC AI™ Stanson's HCC Alerts. Read their stories and more from our proud members.
Care More, Code (More) Accurately with Guidance Delivered Directly to Providers at the Point of Care
Watch this session to hear and learn from BJC's Dr. Nathan Moore, Medical Director, and Shannon Forman, Clinical Documentation and Quality Supervisor, about their successful HCC journey.
2022 Coding and Medicare Reimbursement: What Providers and Payers Need to Know
Understanding how HCC codes work and why they matter is essential for reimbursement in 2022 and beyond. One of the best ways to ensure accurate HCC coding now and in the future is having the right tools to capture codes for every patient.
Care More, Code Less
Using Actionable HCC Alerts to Increase Efficiency, Improve Outcomes and Increase Revenue
HCC Program Leads to Millions in Revenue
See How Community Health Network Saw Financial Impact of $13 Million
Success Story Video: Dr. McGill, from Community Health Network, shares the impact of HCC alerts.
Hear from Dr. McGill from Community Health Network about their $5 Million Financial Impact in 2020 using HCC Alerts.
Indiana Health System Boosts Bottom Line by $7 Million with HCC Alerts
With a simple change, one health system boosted its bottom line by more than $7 million. What was that change?
HCC Coding with Sparrow Health Webinar
Navigating the intricacies of HCC Coding can pose substantial challenges for health systems. Discover how Sparrow Health overcame these, while fostering provider engagement in the EHR.
See How We Can Help Guide Providers And Payers For Overall Improved Care.
Fill out the form below to connect with our team. We look forward to hearing from you.