Regional Plan Sees Annualized $357,000 HCC Gain with MA Chart Recoding and Reprocessing
Regional Plan Sees Annualized $357,000 HCC Gain with MA Chart Recoding and Reprocessing
2 PagesA regional health plan asked Change Healthcare to perform recoding/reprocessing on a sample selection of 147 Medicare Advantage members. Chart reviews—conducted with best-in-class, AI-driven coding capabilities—identified new or additive hierarchical condition categories (HCC) totaling $30,291, or about $357,000 on an annualized basis. Customer Regional health plan Challenge Ensure Appropriate Risk Adjustment Scores by Harnessing Automation to Retrospectively Review Medicare Advantage Charts for Missing HCCs. Products AI-Driven Coding Solution Results New or additive HCCs totaling $30,291—a 20%-30% improvement over incumbent manual HCC review performance Case Study Insight. Innovation.
