Services/Core Services
HCC / Risk Adjustment Coding
CMS-HCC risk adjustment coding that accurately reflects patient acuity for value-based contracts.
The problem
Under Medicare Advantage and other value-based contracts, revenue depends on RAF scores accurately reflecting patient complexity. Incomplete documentation or missed chronic conditions can understate acuity, reduce risk-adjusted revenue, and create audit exposure if conditions are coded without adequate support.
How we solve it
Our coders specialize in CMS-HCC risk adjustment models, reviewing documentation against MEAT criteria (Monitored, Evaluated, Assessed/Addressed, Treated) to ensure every HCC captured is both accurate and defensible — protecting revenue and reducing audit risk for value-based-care and Medicare Advantage practices.
Our process
- 1
Chart review
Documentation is reviewed against active and suspected HCC conditions.
- 2
MEAT validation
Each condition is checked for Monitor/Evaluate/Assess/Treat documentation support.
- 3
Gap reporting
Suspect conditions and documentation gaps are reported back to providers.
- 4
RAF impact tracking
Coding outcomes are tracked against RAF score and risk-adjusted revenue goals.
What's included
- CMS-HCC and HHS-HCC model coding review
- RAF score impact analysis
- MEAT-criteria documentation audits
- Suspect condition and gap-closure reporting
- Provider education on risk adjustment documentation
- Retrospective and concurrent chart review
Benefits & results
Defensible RAF scores
Every captured HCC is backed by MEAT-compliant documentation.
Value-based readiness
Built for Medicare Advantage and ACO risk-sharing arrangements.
Provider education
Ongoing feedback helps providers document acuity more completely.
HCC / Risk Adjustment Coding FAQ
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