Funding Principles

Posted on August 1, 2019June 23, 2020 by Jude Pierre

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