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Higher MRA Scores with Compliance Assurance
Our HCC/HHS coding service ensures accurate and detailed documentation to capture chronic and acute conditions. By adhering to CMS and ACA (Affordable Care Act) guidelines, we help maximize risk-adjusted payments, improve MRA scores, and ensure compliance with evolving healthcare regulations.
helps with
- Chronic and acute condition documentation
- Risk-adjusted payments for Medicare and ACA plans
- Enhancing accuracy in diagnosis and treatment plans
Continuous Monitoring and Annual Refresh
Comprehensive coding updates and annual refreshes to ensure accurate condition capture year over year. Our coding process includes ongoing monitoring, the use of MEAT (Monitor, Evaluate, Assess, Treat) criteria, and alignment with ICD-10 codes to maintain proper diagnosis linkage and enhance payment accuracy.
helps with
- Routine audits and coding accuracy
- Education about specific documentation standards
- Provider education about MEAT and specific
documentation standards
Regulatory Complexity & Compliance Risks
Navigating evolving CMS and ACA regulations can be overwhelming. Our AI-powered solutions ensure compliance with the latest guidelines, reducing audit risks and safeguarding reimbursements.
Provider Education & Engagement Gaps
Inconsistent documentation often stems from knowledge gaps. We empower providers with real-time guidance, MEAT-based education, and actionable insights to improve documentation accuracy and risk adjustment scores.
Inconsistent Coding & Data Integrity Issues
Missing, incomplete, or inaccurate coding can lead to revenue loss and compliance risks. Our service enhances coding precision by identifying discrepancies, clarifying documentation, and improving claims accuracy.
Measurable Impact
Optimized Revenue Capture
Through accurate risk-adjusted documentation, proactive auditing, and streamlined workflows, our solutions help maximize reimbursements and generate additional annual revenue.
Enhanced Productivity & Workflow Efficiency
Our solutions reduce administrative burden, automate compliance checks, and enables providers to focus on high-value activities.
Faster Claim Processing & Reduced Denials
By improving documentation quality and coding accuracy, we accelerate claim submissions, reduce processing delays, and improve cash flow—leading to fewer denials and faster reimbursements.
Data Collection & Risk Assessment
We gather patient records, claims data, and provider documentation, applying AI-driven analysis to identify chronic conditions and risk gaps.
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AI-Powered Code Validation & Documentation Review
Our system cross-checks documentation with CMS & ACA guidelines, ensuring diagnoses align with MEAT (Monitor, Evaluate, Assess, Treat) criteria for risk adjustment accuracy.
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Compliance & Audit Readiness
We conduct in-depth coding audits and real-time documentation checks to mitigate compliance risks, ensuring alignment with regulatory requirements.
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Continuous Monitoring & Annual Refresh
With ongoing tracking and yearly reviews, we help maintain documentation integrity, update risk scores, and enhance payment accuracy.
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HCC (Hierarchical Condition Category) coding is a risk-adjustment model used by CMS to predict healthcare costs based on chronic conditions. Accurate coding ensures appropriate reimbursements and compliance with Medicare and ACA plans.
Our AI-powered platform automates documentation reviews, identifies coding gaps, and enhances accuracy by aligning with MEAT criteria and regulatory standards. This reduces manual effort, improves compliance, and maximizes risk-adjusted payments.
Yes! Our platform seamlessly integrates with most EHR systems, ensuring smooth data exchange, real-time documentation validation, and workflow automation without disruption.
Regular audits are essential for compliance and financial integrity. We recommend ongoing monitoring with annual refreshes to ensure accurate risk-adjusted payments and documentation quality.
It’s easy! Book a free audit with our team, and we’ll assess your current documentation processes, identify improvement areas, and implement AI-driven solutions to optimize your coding workflow.
Get our Capability Deck
A quick snapshot of everything we do, along with case studies and insights from our experience.
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Accelerated Outcomes
Value-driven Collaboration
Compliance Assurance
Bring a change to your Healthcare Operations
A partnership with HOM gives you an inherent:
Adherence towards federal, state, and organizational compliances, as well as safeguarding patient data.
Sense of ownership and commitment towards providing value.
Focus on speed, accuracy, efficiency, and optimal outcomes.
Sense of security and transparency through periodic reporting and actionable insights.
Connect with our experts for a quick analysis and possibilities.
