Aug 1st, 2012
By Holly J. Cassano, CPC Proper hierarchal condition category (HCC) classification depends on a plan’s ability to obtain accurate diagnostic HCC information and report that information accurately to the Centers for Medicare & Medicaid Services (CMS). If a plan focuses solely on disease management to decrease costs (neglecting to develop an effective HCC strategy), it ...
Aug 1st, 2012
By Serine A. Haugsness, CPC The concept of risk adjustment was “born” upon passage of the Balanced Budget Act of 1997 and refined by the Beneficiary Improvement Act of 2000, which mandated that the Centers for Medicare & Medicaid Services (CMS) implement risk adjustment for Medicare Advantage organizations (MAOs) in 2004 and achieve 100 percent ...