Healthcare providers routinely feel weighed down by inefficient risk adjustment processes. Manual HCC coding is frustrating, time consuming, and leads to missed diagnoses – leading you to miss out on Medicare Advantage funding.
HCC Assistant, our NLP-driven software, helps you:
HCC Assistant is an EHR-integrated HCC coding platform that saves providers hours of repetitive work and helps the average practice increase their RAF scores by 35%.
The tool leverages advanced Natural Language Processing (NLP) to analyze structured and unstructured data in the patient’s medical chart. It then uses complex rules to find diagnoses that may have been overlooked before displaying the HCC code suggestions in real time via the EHR.
Open your patient’s chart and let the HCC risk adjustment app automatically analyze the clinical information directly from your EHR or notes.
Review the suggested HCC codes and select the ones you want to document. You can also write your Plan of Care in the HCC Assistatnt.
Click “Submit” to add selected HCC codes to the Assessment and Plan!
HCC coding is a big time-suck for providers and takes their attention away from patients.
The HCC Assistant undertakes all the complex, time-consuming analysis over – empowering providers to simply review the recommendations and submit accurate HCC codes.
Inaccurate HCC coding means your RAF scores may be lower than they should, leading you to miss out on Medicare Advantage funding.
The HCC Assistant reviews the patient chart’s data to suggest diagnoses that may have otherwise been missed, with 97% accuracy. This has led to Medicare funding increasing by 11% for HCC Assistant users.
With data stored in multiple systems, the process of manually combining sources to gain an accurate picture of patient health is difficult and time-consuming.
The HCC Assistant uses NLP to analyze information from all sources and fill gaps in your patient data – allowing you to capture all possible HCC codes for your patients.
Instant Access to Patient Data:
The HCC Assistant centralizes and analyses all patient data, from unstructured to structured data.
Automatic care plans:
The HCC Assistant suggests a comprehensive plan of care based on each patient’s medical history.
Seamless compliance:
The HCC Assistant is 100% compliant with all regulations and regularly updated to ensure best practices are followed.
Accurate documentation of patient conditions is critical to predict the risk and future cost of your Medicare Advantage patients.
The following example shows how the RAF score for a 78-year-old male can be significantly raised through accurate documentation and HCC coding – resulting in thousands of dollars in additional funding.
| Risk adjustment factor (RAF) | RAF score | Expected annual expenditure and funding |
|---|---|---|
| Male 75 to 79 years old 1.062 $9,611 | 1.062 | $9,611 |
| HCC 86, Acute myocardial infarction 0.282 $2,552 | 0.282 | $2,552 |
| HCC 111, Chronic obstructive pulmonary disease 0.355 $3,213 | 0.355 | $3,213 |
| HCC 137, Renal failure stage IV | 0.230 | $2,082 |
Total: |
1.929 | $17,457 |
Our healthcare API empowers payers and third-party vendors to harness advanced HCC coding analysis, facilitating healthcare interoperability and delivering deeper insights to address the evolving needs of patients, providers, and payers.
Payers or third-party vendors connect the API to their existing system.
Claims files are uploaded (PDF or CCDA documents), after which the data is extracted and analyzed using intelligent rules.
The API delivers analysis in JSON format that can be retrieved in seconds.
