From concept to application, you'll learn about the complexities of HCC coding, diagnoses codes and risk codes, the interplay of quality all the way through to revenue.

  • Navigate the coding and documentation paradigm shift
  • Master the mechanics of hierarchical coding
  • Decode the inner-dependencies of HCC coding---diagnoses codes, risk scores and revenue
  • Understanding the rules of engagement to evoke evidentiary data needed
  • Sharpen your skills with RADV mock audit fire drills
  • Distinguish how coding impacts the larger health plan organization from a financial context
  • Demystify the fine line between coding and over coding
  • Identify the common coding challenges and learn how to become a troubleshooter for your provider offices

Our six-hour online course covers the entire HCC coding landscape

Module 1: Why Do We Have Risk Adjustment? Introduction

  • Define the purpose of Risk Adjustment in CMS payments
  • Uncover health care program types that use Risk Adjustment for payments 

Module 2: Risk Adjustment Overview for the Coder

  • Review the CMS HCC timeline of payments
  • Understand HCC categories and how to calculate your RAF score
  • Learn how six disease interactions increase a RAF score

Module 3: Documentation and Coding for Risk Adjustment

  • Understand the difference between coding history v. active conditions
  • Recognize the most common guideline changes for 2017/18 ICD-10-CM

Module 4: Medical Record Requirements for Mock Audits

  • Recognize the steps and identify criteria required for a mock audit
  • Understand how to use mock audit results to reduce future risks

Module 5: Concurrent Workflows to Reduce Risk

  • Understand strategic initiatives that can be implemented for improved reporting and provider support
  • Review workflow processes in the healthplan and provider office to reduce risks of under-reporting & over-reporting

Module 6: HCC Coding-Coding Impacts

  • Review case study examples to determine missed conditions and RADV risks


$700 Enroll Now