How to Boost HCC Coding Accuracy?

How to Boost HCC Coding Accuracy?

Posted on October 15, 2020

The Hierarchical Condition Category (HCC) is a risk adjustment platform used for the prediction of the cost that beneficiaries using medical insurance will get. This amount will then be reimbursed to the healthcare organizations treating the patients. Hence, the cost prediction is important as it impacts the functioning of the hospital.

Every HCC model utilizes a Risk Adjustment Factor (RAF) or every patient enrolled and gathers specific information. This information is then analyzed to create a virtual image of a patient to predict the total cost of healthcare infrastructure used. It helps the organization to judge the risks, check the financial viability, and provide better care to the patients accordingly.

How HCC coding accuracy can be improved?

As you can understand that the prime step is to acquire data regarding every patient, the HCC model. Hence, the documentation of the patients should be done accordingly in the healthcare division. Here is how HCC coding can be made more accurate.

  1. Accurate list of problems
    Electronic medical records are the prime base to find information regarding patients. Over the years, a lot of data has been entered into the problem list. Inactive diagnoses, duplicate entries, and other important areas with discrete data should be identified and highlighted. Removing such information or identifying them will be ideal for HCC Coding. When the problem list is accurate, the risk analysis will be better too.
  2. Patients visible in every calendar year
    HCC coding needs to identify patients with chronic ailments who have not visited a clinic in a year. The identification has to be done by the workgroup and then matched with the coding gaps. This should be done every three months to improve the accuracy of HCC coding.
  3. EMR optimization and decision support
    Apt coding has to be done in the workflow handling daily encounters. The incorporation of decision support tools in the HCC coding will enhance quality and accuracy.
  4. Educating primary data handlers
    Clinicians and other technical professionals handling data should be educated to maintain accuracy. They should learn the specificity of the tools and know what to do in a workflow to ensure proper medical data entry.
  5. Performance tracker
    Result metrics are an important part of the HCC coding. It helps in tracking performance and showcasing places where improvement can be done.


Choosing the right HCC coding agency also becomes a factor in this aspect. This is how a healthcare organization can escalate the level of HCC coding accuracy.

Choose Flatworld Solutions for Highly Accurate HCC Coding Services

Flatworld Solutions has been a pioneer in providing the best quality HCC coding services and a series of other medical billing and coding services to global clients. We have some of the most experienced and skilled HCC coding specialists on board who can cater to all your requirements in a hassle-free manner. We leverage the latest and the best HCC coding software and tools while delivering the best quality services to clients around the globe.

If you are looking for a reliable and accurate HCC coding service providing company, then you have come to the right place. Get in touch with us today!

Interested to know more?

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  2. The Pros and Cons of Outsourcing Medical Billing
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