CMS requires insurance plans submit claims using specific coding for Hierarchical Condition Categories (HCC) for potential risk adjustment which estimates future year's predicted costs for enrollees. Since HCCs healthcare coding is tied to revenue, there is a clear risk. We can extract all HCC codes to support CMS Advantage plans in finalizing accurate risk valuation of their membership and submit broad and accurate data before CMS deadlines.

Most health plans use HEDIS (Healthcare Effectiveness Data and Information Set) as a instrument to appraise the level of service their providers deliver and to measure performance on important length of care and service. It might be puzzling to conduct monitoring activities using HEDIS, Going through hundreds and thousands of charts will require a lot of experts working on it for a short period of time. As a reliable medical coding company with relevant experience in coding we provide HIPAA-compliant HEDIS coding services to help insurers meet NCQA's quality goals and healthcare providers to maximize reimbursement. We have the expertise to meet your complex coding and data abstraction requirements.