Risk Coding
“ …when you set up processes like this, it makes you not have to worry about the coding –– you worry about just practicing good medicine.”
In this episode, hosts Dr. Hart and Katila Farley, RN, CMOM, are diving into HCC (Hierarchical Condition Category) and RAF (Risk Adjustment Factor) coding –– crucial value-based healthcare components. Joined by expert guests, they discuss the intricacies and importance of coding practices in documenting a patient's disease burden and how this documentation doesn’t just factor into reimbursement but plays a vital role in improving patient outcomes. They also explore how accurate coding can free up physician bandwidth for more direct patient care. Dr. Hart and Katila also touch on the recent changes in HCC coding and the crucial role of comprehensive education for physicians.
In this episode, we’re joined by:
Sara Faust, BSN, RN, CPC, CRC, Senior Clinical Analystat Blue Cross Blue Shield of Alabama
You can connect with her here.
Justin Williford, BSN, RN, PMP, CPC, CRC, CCM, Senior Clinical Consultant at Blue Cross and Blue Shield of Alabama
You can connect with him here.
Samuel “Le” Church, MD, MPH, CPC, CRC, FAAFP
Joseph Hafner, Upperline Health
Episode topics:
02:11 Intro to HCC Coding
05:08 Accurate Documentation
10:11 Challenges and Common Errors in HCC Coding
14:49 Workflow Tips and Practical Advice
33:52 Importance of Comprehensive Documentation
34:56 Introduction to SNOMED and ICD Codes
36:07 Leveraging Technology and Teamwork
39:10 Team-Based Documentation Benefits
43:20 Challenges and Opportunities with AI in Healthcare
48:04 Version Changes in HCC Coding
53:33 Educating Physicians on HCC Coding
