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