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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?


  2. #2
    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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