Risk Adjustment Solutions

Risk Adjustment

Our certified coders submit claims mapped to over 70 HCC codes in the RA model.

As Risk Adjustment plans become more common, Global Healthcare Resource can manage these challenges.

Only medical coders who have been trained in Hierarchical Condition Categories (HCC) coding can ensure timeliness and accuracy. Our team of professionals are proficient in the details of the latest payment methodologies, leaning on our accuracy and knowledge to code to the highest level of specificity.

Every missed code is a potential care gap.

We excel at optimizing risk adjustment scores by lowering cost and improving quality of care. Our trained and certified coders submit claims that are mapped to over 70 HCC codes in the RA model. Our coders and nurses work together, being proactive to engage patients who have care gaps to schedule appointments. Our specialists take initiative in reviewing records to capture missing diagnosis and record a thorough HCC code review.

What We Can Offer:

Retrospective services
Concurrent Chart Review
Data submissions
RADV, HEDIS, or Medicare Advantage audit support

The integrity of your data is our #1 priority.

SOC 2 Type 2 Compliant.

SOC 2 Type 2 audits determine how well an organization safeguards customer data and how those controls operate over a 9-month (minimum) time frame. Reports are issued by third party auditors who review the following principles: Security, Confidentiality & Availability. Global Healthcare Resource is proudly SOC 2 Type 2 compliant.

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SECURITY

The security principle addresses whether an organization's system is protected (both physically and logically) against unauthorized access.

AVAILABILITY

The availability principle addresses whether the services an organization provides is operating with the type of availability that client's expect.

CONFIDENTIALITY

The confidentiality principle addresses the agreements made with clients in regard to how their information is used, who has access to it and how it's protected.

Global Healthcare Resource