Today, ICD-10-CM coding is ever-evolving and complex. e4health strives to simplify complicated coding methods by providing a thorough understanding of Risk Adjustment and Hierarchical Condition Categories (HCCs).
Diagnoses have an increasing role in reimbursement. The Risk Adjustment (RA) payment model is based on the assignment of diagnoses to disease groups known as HCCs. HCCs capture the severity of illnesses as well as acute and chronic conditions for patients. Risk scores associated with HCCs are tied to reimbursement and based on documented diagnoses.
Unparalleled Risk Adjustment and HCC Auditing Expertise
Boasting years of experience and the successful review of thousands of records, our credentialed HCC coders and auditors maintain exceptional accuracy and deliver meticulous work. With our proprietary data analytics tool, we identify potential losses and gains and highlight missed opportunities. We then conduct education sessions that determine pitfalls, patterns, and trends that can lead to optimized RAF (Risk Adjustment Factor) scores.
No one is better prepared to handle RA/HCC assessments and education than our e4health subject matter experts. Unmatched expertise:
Credentialed leadership team: RN, RHIA, RHIT, CCS, CCDS, CDIP, CRC, CPC
Advanced knowledge of the CMS landscape
Provided significant consulting input on various federal agency coding procedures
Partnered with providers in leading medical centers to assess, educate, and implement inpatient & outpatient CDI practices
Reviewed over 40,000 records while managing audit processes
Performed the Secondary Validation Audit (SVA) for a Risk Adjustment Data Validation (RADV) audit for the past five years
Presented education sessions that identify pitfalls, patterns, and trends that can lead to optimized RAF (Risk Adjustment Factor) scores
“e4health is always available and provides additional support whenever requested, even at times with little notice due to volume increases. Their quality including the constant internal audits of their staff makes e4health a better partner.”
Coding Executive, Mid-Sized Northeast Health System
Coding and CDI Capabilities
Improve quality and productivity goals with our AHIMA and AAPC certified medical coding team.
Conduct audits and deliver targeted education with our domestic full-time experts.
Education and Training
Mid-Revenue cycle, medical coding, and CDI education and training that maximizes professional performance and optimize outcomes.
Capture documentation specificity and maximize efficiency with a consultative approach.
Risk Adjustment and HCC Solutions
Delivering value-based reimbursement support with audit accuracy, efficiency, and clear guidance.
Coding Integrity Software Solutions
Access detailed analysis and customizable reporting for any audit type and quickly analyze productivity and reimbursement.