How HCC Coding Technology Can Improve Pre-Visit Planning

Value-based care (VBC) providers could deliver far better service for their patients – they just need to rethink how they manage their data. Pre-visit planning enables providers to anticipate care needs and focus exclusively on the patient; the only question is how to eliminate fragmented data and ensure providers have the information they need.  

This blog explores how HCC coding can support pre-visit planning and transform patient care. With the right processes and technology, VBC providers will finally give patients the experience they deserve. 

Understanding the Power of Pre-Visit Planning 

What is Pre-Visit Planning? 

Pre-visit planning is the process of gathering, organizing, and analyzing health information before patients arrive for their appointments. Relevant data, such as previous medical notes or the patient’s treatment plan, is ready at-hand and structured in an efficient, easy-to-use format. 

Given that the average physician spends more than a third of their visit looking up medical records, this has very clear benefits. Providers can therefore spend less time at their computer – and more time engaging directly with the human being in front of them.  

Benefits of Pre-Visit Planning 

A large meta-analysis of papers from over 10 countries found overwhelming evidence that pre-planning is effective in clinical practice. Alongside the clear improvements to patient care and efficiency, there are a number of further benefits pre-visit planning can deliver for healthcare providers: 

• Reduce Delays: Appointments are more likely to run on time and reduce wait times for other patients – ultimately improving the overall patient experience. 

• Accelerated Care: Many aspects of care, such as setting up devices or scanners, can be pre-empted and completed ahead of time. 

• Enhanced Relationships: With better communication and more clearly personalized treatment, pre-planning helps to boost patient-provider relationships – and more toward a truly “patient-centric” care model 

But these benefits are all contingent on providers’ ability to implement pre-visit planning processes – which means data must be far easier to access.  

How HCC Coding Technology Helps Providers Overcome Data Fragmentation 

Data fragmentation is a serious problem for healthcare providers. 80% of medical data is unstructured, while providers routinely store patient information across multiple systems which lack interoperability. The impact on pre-visit planning is clear: 

• Poor Data Quality: Medical histories are often incomplete or inaccurate, with important diagnoses siloed at a previous treatment center. Providers may therefore prepare for a visit only to learn a different course of action is required when the patient fills them in on their medical history.  

• Planning Complexity: Administrators and assistants are often forced to spend extra time searching for important information – and may simply not be able to find it. This undercuts the potential efficiency gains from pre-planning and makes the process quite labor-intensive. 

The solution is to eliminate data silos and create a single centralized source for patient medical histories – which is exactly what HCC coding can offer. 

How HCC Coding Technology Helps Providers Implement Pre-Visit Planning 

Hierarchical Condition Category (HCC) coding is a system that uses patient diagnoses and demographics to predict healthcare costs – enabling healthcare plans to adjust reimbursements based on individual patients’ risk scores. These codes can also dramatically improve pre-visit planning through: 

• Saved Time: Pre-selecting or flagging potentially relevant HCC codes reduces the time providers spend on risk-adjustment during patient visits. This ensures the visit can be focused on the patient’s needs without compromising insurance claims or risking missing out important documentation.  

• Streamlined Data: HCC codes streamline patient data and make it easier to centralize and access relevant information ahead of an appointment. For example, the 2024 CMS-HCC model classifies about 74,000 ICD-10-CM diagnosis codes into just 266 CMS-HCCs. This gives providers a far clearer overview of the patient’s medical conditions and relevant health factors.  

• Enhanced Insights: HCC coding is designed to anticipate future care requirements – making it a powerful fuel for long-term care planning. Accurate coding enables providers to not only plan for the impending visit, but also future needs.  

The only question is how you manage the burden of manual coding. 

Automated HCC Coding: The Key to Pre-Visit Planning 

HCC coding is a heavy administrative burden for healthcare providers. Physicians must constantly use reference sheets to recall which code they need, which takes their focus away from patients and contributes to poor workplace morale. Worse still, they must deal with data gaps and errors that make it hard to deliver accurate or reliable coding. 

That is why so many providers are adopting HCC Assistant: a solution that leverages natural-language processing (NLP) to produce automated HCC coding recommendations at the point of care. It ingests both structured and unstructured patient data to: 

• Eliminate data gaps 
• Improve documentation 
• Reduce physicians’ administrative burden 

Ultimately delivering coding recommendations with 98% accuracy – and allowing your providers to select and reject codes in seconds based on their expert assessment. 

Want to explore how it could take the pressure off your providers’ shoulders? 

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