The benefits of risk adjustment services for Healthcare providers and payers
Risk adjustment helps ensure accurate payment rates for healthcare providers by analyzing a patient's demographics and health status to estimate the cost of care for patients with varying levels of risk.
Risk adjustment equates a person's health status to a number: a risk score, or risk adjustment factor (RAF), to predict costs and help ensure providers are paid fairly for treating patients with complex medical needs. Each year, that score is assigned using Hierarchical Condition Category (HCC) coding, a list of diagnoses valued for risk adjustment and updated annually by HHS.
ADEC Healthcare's risk adjustment services include HCC coding, documentation review, provider education, risk assessment, analytics and reporting, and compliance/audit support , helping providers and payers stay accurate, compliant, and cost-efficient.