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HCC = Big check from Medicare?

  1. #1
    Default HCC = Big check from Medicare?
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    I have a coworker in the office that is promoting HCC Risk Adjustment. She claims that Medicare will send us a big check every year for using the HCC ICD10 codes. I understand that higher risk will increase the level of E/M but find it hard to believe that Medicare will send us additional money at the end of the year. I can find nothing that states this is an actual thing.

    Is she correct?

    Also, with the new proposed E/M payment policy, will this HCC even affect payment if it passes?

    Confused.

  2. #2
    Default
    No, HCC score is for determining the amount the payer gets from the government, not how much the provider gets as that is based on contract with payer.
    CRC (2018), CPC-P-A (2016), COC-A (2016), CPC-A (2015), PAHM (2010)
    Contract/Fee Specialist - Remote

    20 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

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