HCC Reviews

smihm

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Would anyone be willing to share their current workflow for HCC chart reviews?
Are you doing Prospective or Concurrent reviews ? My group is doing prospective reviews- we are looking through the chart prior to the upcoming appt , identifying potential HCC conditions- so the Physician can assess at time of visit - this has been very successful.
Due to recent changes in some of our risk based contracts , I am leaning more toward concurrent reviews as the particular payer is solely using codes submitted on the claim. The down side to this at least from what I can tell - is my staff would not be "data mining" the entire chart - as time would not permit. I do believe do both prospective and concurrent together is the most beneficial, however staffing is a an huge
Any insight would be greatly be appreciated
Thanks
 
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