Request a 15-minute Demo
The HCC Validator analyzes your clinical note, validates diagnosis codes in the assessment section against MEAT criteria and gives a clear pass or fail result for those codes. Request a demo of the HCC Validator today!
Reducing Audit Risk with HCC Validator
Submitting inadequate supporting documentation for HCC codes places healthcare providers at risk for decreased payments, audits, and financial penalties. Inferscience’s HCC Validator® takes the guesswork out of risk adjustment documentation. Clinicians and coders alike can be confident that patients’ ICD-10 HCC diagnoses are documented accurately and thoroughly.
How it Works
The HCC Validator® uses advanced NLP technology to instantly validate HCC codes against MEAT criteria and issues a clear “Pass” or “Fail” grade. Because it’s SaaS-based, it works with leading EHRs or can be used as a standalone solution.
Powerful Technology Features
- Advanced NLP technology that instantly analyzes and audits all ICD-10 HCC diagnoses.
- “Pass” or “Fail” indication for each documented code.
- Detailed information about what needs to be reviewed and corrected per MEAT criteria.
- Insight into the data sources and rule logic used to audit the HCC codes.
- Integrates with leading EHRs or can be used as a standalone solution.
- Save hours spent researching source encounter notes for supporting documentation.
- Reduce risk from costly audits and penalties.
- Increase payments from risk adjustment contracts through submission of accurate supporting documentation.
- Stay in compliance with HCC reporting requirements.
- Prove that patients’ conditions are evaluated, monitored, and treated during face-to-face encounters.
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|