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HCC Capture
Improve HCC coding to optimize Medicare Advantage reimbursement
SPEAK WITH AN EXPERTR1 HCC Capture is powered by advanced technology and audit expertise to identify and validate high-volume claims that have hidden reimbursement potential. With R1 HCC Capture, providers can confidently navigate the complex coding landscape by ensuring that the appropriate hierarchical condition category (HCC) is captured on every encounter.
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Target complete documentation with a compliance-first approach
R1 HCC Capture uses analytics and proprietary rules to efficiently review and identify HCC coding gaps, driving earned reimbursement and complying with regulatory guidelines. Our non-disruptive approach is designed to relieve the documentation burden on clinicians and staff, with skilled coders who review every HCC opportunity.
R1 HCC Capture seamlessly integrates advanced technologies with expert coding services to review high volumes of ambulatory encounters and identify opportunities for adding or deleting HCC’s. As Medicare Advantage plans grow, we help keep you contract compliant and ensure your expected costs are correctly captured.
Our solution automatically finds encounters that have been incorrectly or insufficiently coded and routes the records for review by our coding and billing experts. This ensures full documentation accuracy to help capture and elevate Risk Adjustment Factor (RAF) scores, improving revenue and ensuring high quality care for Medicare Advantage patients.
With our safety-net, pay-for-value model, you only pay when an HCC code is added, modified or deleted—helping to ensure maximum return on investment.
Providers are experts at patient care, not coding, leading to gaps between the clinical documentation and HCC coding. Our coding experts leverage advanced technologies to identify and correct documentation gaps and coding inconsistencies that impact revenue and the patient experience.
A simple solution to cut through HCC complexity
Overcome HCC challenges with an intelligent coding engine identifying coding gaps and routing claims to coding experts for reconciliation and resolution.
Complete safety net solution
Designed to process high-volume claims and identify missed revenue
Only pay for value received
With our value-based approach, you pay only for qualified HCC events with RAF impact
Non-disruptive approach
Leverage advanced analytics and the expertise of our team of auditors to relieve the documentation burden on clinicians and administrative staff
HCC Capture by the numbers
Medicare Advantage claims miscoded
nearly
20%
on average
RAF value found
approximately
$250K
per month
Positive impact to RAF scores
at
Day 1
after implementation
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