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Medicare Risk Adjustment – HCC Coding

The Medicare Risk Adjustment (HCC Coding) course is designed to introduce students to the concept of insurance companies receiving funds based on Hierarchal Conditions Codes (HCC). Sicker patients or patients with chronic disease will have higher healthcare costs associated with their care.  Medicare has developed a system that will reimburse health plans and providers additional amounts for caring for patients who may require more services.

Module 1Introduction and Objectives
Lesson 1Intro and Objectives
Lesson 2Poll/Survey
Module 2Definitions and History of HCC Coding
Lesson 1Definitions
Lesson 2History of MRA and HCC
Module 3Specific HCC Codes and Factors
Lesson 1List of HCC Codes
Lesson 2HCC Codes and Their Factors
Module 4Medicare Advantage Funding from CMS
Lesson 1Funding Principles
Lesson 2Sample Medicare Advantage Companies
Module 5Case Scenario
Lesson 1Limited Documentation
Lesson 2Complete Documentation
Lesson 3Potential Revenue Loss
Module 6Sample Reports
Lesson 1MRA Reporting by Plan
Lesson 2High Cost Patient with LOW MRA
Lesson 3Help From the Health Plans
Module 7HCC Coding Tools and Resources
Lesson 1HCC Coding Tools
Module 8Summary
Lesson 1Summary