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Risk adjustment coding can feel mysterious when you’re first stepping into this world, but behind every code is a direct impact on patient care and value-based reimbursement. In this session, we’ll break down the big picture of risk adjustment, where it fits into value-based care, and why Certified Risk Adjustment Coders (CRCs) play such a pivotal role in ensuring accurate documentation and reporting. You’ll gain clarity on how retrospective reviews support both financial integrity and the continuity of care, while also seeing how risk adjustment connects to broader healthcare goals.

After building that foundation, we’ll roll up our sleeves and step into the real work of a CRC. Together, we’ll walk through mock patient charts, following the same steps a risk adjustment coder takes in a retrospective review. We’ll then identifying conditions and translating provider documentation into accurate HCC coding. This hands-on practice will give you a true sense of what it’s like to be a CRC—beyond the theory and guidelines. Whether you’re considering the CRC credential, looking to strengthen your current risk adjustment knowledge, or simply curious about how HCC coding really works in practice, this webinar will provide the insight you need. Come learn from risk adjustment subject matter expert with experience as a risk adjustment auditor and manager.

Learning Objectives/Agenda

• Explain how risk adjustment fits into value-based care (VBC)
• Clarify the “why” behind retrospective reviews
• Recognize key documentation requirements for HCC capture
• Apply coding principles to real-world scenarios
• Health plan and ACO staff

Why is this topic important?

Risk adjustment has never been more critical to the future of healthcare. As value-based care (VBC) models expand, accurate HCC coding is at the heart of how payers and providers measure patient complexity, allocate resources, and ensure patients with chronic conditions receive the care they need. With CMS continuing to refine risk adjustment models and compliance requirements, coders must not only know how to code—but also why it matters in the bigger picture of healthcare transformation. With CMS announcing a ramp-up of RADV audits in summer 2025, now is the time for coders to sharpen their skills and ensure accuracy, compliance, and confidence in ICD-10-CM and risk adjustment coding.

Who would benefit from this topic?

• Coders/students preparing for the CRC credential or a career in medical coding
• Experienced medical coders
• Auditors and compliance professionals
• Clinical documentation improvement (CDI) specialists
• Provider educators
• Health plan and ACO staff

What is the presenter's background/expertise on this topic?

As a Senior Educator for a leading MAO, Danielle educates leadership on risk adjustment compliance and best practices. In addition to documentation and coding education to providers and coders. She has experience in coding, auditing, and managing teams of risk coders across multiple types of models, including Medicare Advantage, ACA, and Medicaid risk adjustment programs. That hands-on experience has given her a deep understanding of both the technical side of HCC coding and the strategic role it plays in value-based care. Through her business, Medical Coding and Documentation Education (MCDE), and as an AAPC CRC VILT instructor and national speaker, she's had the privilege of educating hundreds of coders, auditors, and providers nationwide on risk adjustment, HCC capture, and documentation best practices. Her focus is on demystifying risk adjustment and helping professionals connect the “why” behind the work to the impact it makes on patient care and organizational success.

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