Overview

As healthcare transitions to a value-based care model, the financial burden is shifting from payers to providers. To succeed in this changing landscape, provider organizations must improve documentation, align evidence, and enhance coding quality to maximize reimbursement. With AGS Health’s Hierarchical Condition Category (HCC) coding services, you can positively impact your bottom line while improving your ability to forecast costs and improve patient satisfaction among high-risk populations.

Our certified risk adjustment coding team leverages proven processes and state-of-the-art workflow technologies to enhance physician engagement and prioritize high-value, high-volume encounters. We also apply artificial intelligence to help identify missing diagnoses, estranged evidence, and other issues to ensure optimal reimbursements and better manage at-risk populations.

AGS Health risk adjustment coders review and code using all types of reviews:

Risk Adjustment Overview

Deep dive retrospective reviews uncover all types of missed diagnoses, estranged evidence, and other issues often buried in ancillary reports and supplemental documentation.

Concurrent reviews to code current encounters and ensure all relevant diagnoses and evidence are documented and built into the patient record and claim submissions

Prospective reviews using outpatient CDI to prepare your physician for the patient visits and ensure they have a checklist, queries, and more to ensure you maximize your RAF score and revenue.