HCC Assistant is an innovative EHR-integrated intelligent HCC coding tool/app which helps providers improve their risk-adjustment documentation in real-time at the point of care by showing all possible HCC-related diagnoses.
New! OCR of scanned documents and conversion to text for HCC analysis!
What is HCC
Hierarchical Condition Category (HCC) and Risk Adjustment is a payment model which identifies individuals with serious or chronic illness and assigns a risk factor score to them based on the individual’s health conditions and demographics. The risk adjustment score is then used by CMS to determine the payment to Medicare Advantage Plans. There are more than 9000 ICD-10 codes that map to 79 HCC categories in the HCC Risk Adjustment model. The submitted diagnoses and the plan of care related to the diagnoses must be documented in the patient chart by the health care provider at least once every calendar year in order to meet CMS guidelines.
What does HCC Assistant do
Real-time HCC diagnosis guidance.
HCC assistant parses the patient chart and shows all possible HCC related diagnoses in real-time to the provider so that HCC opportunities are not missed while documenting the patient visit. It thus improves hcc risk adjustment coding and prevents retrospective queries to the providers which frequently go unanswered.
Integration in provider’s workflow
The HCC Assistant suggests possible HCC-related diagnoses while the provider is documenting the encounter. It can also suggest plan of care documentation for a diagnosis, which can be edited easily and then added to the plan section of the chart.
Standalone HCC Assistant
The standalone version of HCC Assistant allows users to analyze any digital clinical document for HCC diagnoses by copy pasting the document into HCC Assistant without the need for any kind of integration .Within seconds the Assistant displays all possible HCC related diagnoses and ICD10 codes which can be easily copied and used elsewhere.
HCC Assistant has the ability to analyze text from uploaded pdf documents and tiff images using optical character recognition (OCR) technology. This allows you to analyze scanned or faxed lab documents, consults notes, hospital records etc to capture all possible HCC codes for a patient.
Return on Investment
Accurate documentation of patient conditions is critical to predicting the risk and future cost of your Medicare Advantage patients. This graphical example shows the baseline RAF (risk adjustment factor) score for a 78 year old male and how the RAF score can be significantly raised through accurate documentation and capture of HCC codes, resulting in thousands of additional dollars in reimbursement.
|Risk adjustment factor (RAF)||RAF score||Expected annual expenditure and funding|
|Male 75 to 79 years old||1.062||$9,611|
|HCC 86, Acute myocardial infarction||0.282||$2,552|
|HCC 111, Chronic obstructive pulmonary disease||0.355||$3,213|
|HCC 137, Renal failure stage IV||0.230||$2,082|
Structured and unstructured data analysis against intelligent clinical rules
HCC Assistant is a cloud based intelligent HCC coding and billing tool built on the Infera CDS platform which is integrated with major EHRs. The platform utilizes advanced Natural Language Processing (NLP) to analyze unstructured data as well as utilizing standardized vocabularies to analyze structured data in the patient chart. The complex intelligent rules built into the Assistant allows it to find diagnoses that may have been overlooked and represent opportunities to improve the documentation in real time. The 2 way integration with EHR allows the provider to add a selected diagnosis and plan of care to the encounter note
Why choose us
- Only solution designed to give real time HCC coding guidance to providers in their workflow
- Real-time analysis of patient chart
- Analyzes structured and unstructured data in HER
- Suggests plan of care which can be edited