Medical Reimbursement Specialist

Medicare Risk Adjustment Data or Hierarchical Condition Categories (HCC)

ICD-10-CM will be in updated on October 1, 2020!

Call our office today to prepare for the transition. If you have a high percentage of Medicare Advantage patients, being prepared for this transition is crucial to your continued healthy bottom line.

Request a copy of 2020 deleted and NEW codes!
** The HCC handout is also available with RAF to analyze its impact on your bottom line. Please call the office to request: 562-430-6847 or email

What is a CMS-HCC Chart Review?

Some chart reviews are done to ensure that deserved reimbursement reaches your practice. The HCC Chart Review is one example.

Through a CMS-HCC chart review, the reviewer gleans out of your documentation those codes that may have been missed; or that may have been omitted from the encounter data submission; or that you may have been unaware merited a separate condition code. Submitting these by the deadline date guarantees that your payments will reflect deserved increases in reimbursement.

As part of the process, you will receive tips on how to improve your documentation to support the diagnosis code assignment.

Your 2019 payments for patients in a Medicare Managed Care plan were based on the diagnoses submitted for those patients in 2018. Likewise, your 2020 payments will be based on what is submitted for 2019 dates of service.

Our staff of certified coders are experienced in abstracting charts for this vital information. We have extensive experience in providing bilingual (Enlish/Spanish) guidance in this area.

How does CMS-HCC work?

What you can do today -

** The HCC handout is also available with RAF or Category. Please call the office to request: 562-430-6847.

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Reimbursement Specialist
Tel: 562-430-6847
Fax: 562-430-6849

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