by RMC Inc. | Apr 29, 2021
The Office of Inspector General (OIG) released a recent report (4/2021) titled “Medicare Advantage Compliance Audit of Diagnosis Codes that Humana, Inc., (Contract H1036) Submitted to CMS”, which should wave a flag for compliance and Health Information Management...
by RMC Inc. | Mar 30, 2021
The words “Hierarchical Condition Categories” or HCCs can conquer up some anxiety for HIM Coding, and Clinical Documentation Integrity (CDI) professionals, even for Revenue Cycle and Compliance leadership. Add to that, the word “audit” and we now have uneasiness and...
by RMC Inc. | Jan 22, 2021
Risk Adjustment coding reviews can take many different shapes and forms. When starting a new project/review, there are many things to consider. A “Project Management” approach is key to success. Project Management includes four phases: Project Planning Phase;...
by RMC Inc. | Nov 17, 2016
Hierarchal Condition Category (HCC) coding plays an increasingly important role in today’s ever-changing world of insurance benefits and reimbursement. With the creation of the Affordable Care Act (ACA), HCC code capture is no longer only for Medicare Advantage...
