HCC Analyzer Content Module Add-on
Optum
The new HCC Analyzer Content Module Add-on revolutionizes the HCC risk adjustment process for coders, billers, and auditors by providing advanced tools to enhance code accuracy and documentation. This innovative tool allows for immediate identification of applicable HCC codes across various model types (CMS, ESRD, RX, HHS-Commercial) and facilitates a deeper understanding through a unique calculator that displays side-by-side HCC coding scenarios.
The HCC Analyzer introduces industry-first “HCC edits,” which highlight clinical and coding documentation improvement opportunities. Users also benefit from streamlined access to ICD-10-CM code guidelines, AHA coding clinic references, and more, enabling both coding compliance checks and HCC reviews in just two clicks. This integration ensures not only clean claims but also a comprehensive review of HCC codes for enhanced documentation accuracy — all in one efficient process.
NOTE: This item is an add-on to our suite of online products. This item may only be purchased online if you are also buying a new subscription to an online application.
The HCC Analyzer Content Module Add-on may be added to these online coding tools:
The HCC Analyzer introduces industry-first “HCC edits,” which highlight clinical and coding documentation improvement opportunities. Users also benefit from streamlined access to ICD-10-CM code guidelines, AHA coding clinic references, and more, enabling both coding compliance checks and HCC reviews in just two clicks. This integration ensures not only clean claims but also a comprehensive review of HCC codes for enhanced documentation accuracy — all in one efficient process.
NOTE: This item is an add-on to our suite of online products. This item may only be purchased online if you are also buying a new subscription to an online application.
The HCC Analyzer Content Module Add-on may be added to these online coding tools:
- EncoderPro.com (Items 1127, 1137, 1221)
- EncoderPro.com for Payers (Item 1145)
- Optum Edge — HCC Side-by Side Comparison Calculator. Compare side-by-side different HCC scenarios based on clinical documentation improvement and code selection to view potential changes in RAF scoring and PMPM from your improved coding and documentation (PLRS for HHS).
- Optum Edge — HCC Coding Analysis With HCC Edits. Similar to claim review, our Optum HCC coding analysis provides clinical and coding documentation improvement “edits” that will assist users to “know what they don’t know” about the HCC diagnosis codes they are billing, and the different clinical issues based on the diagnosis codes and the conditions they represent. This presents users with opportunities to review their documentation processes with their clinicians to be able to accurately capture the patient’s clinical presentation.
- Optum Edge — Optum Exclusive: ICD-10-CM Single Page Display of ALL Guidelines for Multiple Codes. Allows coders to see, on a single page, all the guidelines for multiple diagnosis codes. No more clicking back and forth from codes to guidelines. For any HCC diagnosis codes, you can view chapter, section, range, and code notes, that include excludes 1,2 notes, code first notes, code additional notes, and more. Even AHA coding clinic references and user notes.
- Optum Edge — HCC Code Searching Capabilities. Search among both ICD-10-CM HCC and non-HCC, or HCC only in both Optum’s code searching capabilities or within the ICD-10-CM index. Immediately identify the HCC categories for all HCC model types (CMS, ESRD, RX, and HHS-Commercial HCC).
- Comprehensive HCC Calculator (Multiple model types including HHS) — Review RAF (and PLRS for HHS) scores for multiple model types and reporting years with accurate model type information in an easy-to-use calculator. For CMS model types, users can also review resulting PMPM because of RAF changes, and can see, with full transparency, what goes into the RAF scoring.
- Enhanced Model Type Identification — Improved exposure and display of model types based on reporting year and version.
- BOTH Claim Review and HCC code review in one single tool — Easily add diagnosis codes to the HCC calculator form code ranges, code detail pages, favorite lists, and even the Optum physician compliance editor (claim scrubber) to do fast and efficient claim review AND HCC coding review.
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