Monitor Mondays

Exclusive: Never-Before-Released HCC Data Reveals Possible Link to Under/Over Coding

January 30, 2023 Ronald Hirsch, MD | Knicole Emanuel, Esq. | David Glaser, Esq | Cate Brantley, JD | Frank Cohen, MPA | John Zelem, MD Season 13 Episode 531
Monitor Mondays
Exclusive: Never-Before-Released HCC Data Reveals Possible Link to Under/Over Coding
Show Notes Chapter Markers

Never-before-seen data has revealed that Hierarchical Condition Category (HCC) risk scores could predict under- or over-coding – and it will be the primary topic of discussion during the next live edition of Monitor Mondays.

That’s when senior healthcare analyst Frank Cohen will report on his findings. The HCC risk score is a relative measure of the average health (or lack of health) for a Medicare beneficiary. The higher the score, the more cost to the system, and subsequently, the higher the payment for care. 

Out of this model was born clinical documentation improvement, or CDI – a push to improve documentation so that it improves the reporting of diagnoses and procedures, thereby optimizing the scores. But with this comes the opportunity for abuse. 

So, can the HCC risk score help predict whether a provider is under-coding, over-coding, or coding optimally? 

Broadcast segments will also include these instantly recognizable features:

  • Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.
  • The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Practus, will report the latest news about auditors.
  • Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.
  • Legislative Update: Cate Brantley, legislative analyst for Zelis, will report on current healthcare legislation.
  • Livestream Chat: Dr.John Zelem, founder and CEO of Streamline Consulting Solutions, will join the broadcast for a wrap-up on the morning’s top stories.
Ronald Hirsh, MD
Knicole Emanuel, Esq.
David Glaser, Esq.
Cate Brantley, JD
Frank Cohen, MPA
Chat with John Zelem, MD