Medicare Advantage and the HCC Payment Methodology

Barry Libman Inc. has worked with several insurers and physician group practices to review the medical records of Medicare Advantage patients to assess the accuracy and completeness of ICD-9-CM diagnosis coding.  The goal of these reviews is to identify opportunities afforded by the HCC payment methodology.

Our coding of Medicare Advantage medical records is completed in strict compliance with “ICD-9-CM Official Guidelines for Coding and Reporting,” American Hospital Association's Coding Clinic, and CMS’s “Medicare Advantage Organizations Participant Guide.”